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General NPI Number Information
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NPI Number | 1518375252
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Entity Type | Organization
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Legal Business Name | BARBARINO SURGICAL ARTS, INC.
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 07/25/2014
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Provider Practice Location Address
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Address Line | 1601 PACIFIC COAST HWY STE. 150
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3213
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Country | US
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Telephone | 310-402-2255
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Fax | 310-376-1391
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Provider Business Mailing Address
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Address Line | 1601 PACIFIC COAST HWY STE. 150
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3213
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Country | US
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Telephone | 310-402-2255
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Fax | 310-376-1391
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SHEILA C. BARBARINO
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Credential | M.D.
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Telephone | 310-402-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | A107345
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License Number State | CA
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