Healthcare Provider Details

I. General information

NPI: 1528093085
Provider Name (Legal Business Name): JOHN L BARSTIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23929 MCBEAN PKWY BLDG F STE 215
VALENCIA CA
91355-4466
US

IV. Provider business mailing address

5767 W CENTURY BLVD SUITE 200
LOS ANGELES CA
90045-5632
US

V. Phone/Fax

Practice location:
  • Phone: 661-255-5350
  • Fax: 661-255-9907
Mailing address:
  • Phone: 661-255-5350
  • Fax: 661-255-9907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG39366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: