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General NPI Number Information
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NPI Number | 1700827326
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Entity Type | Individual
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Provider Name | IAN BARE M.D
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 30492 GATEWAY PL STE 110
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City | RANCHO MISSION VIEJO
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State | CA
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Zip | 92694-1862
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Country | US
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Telephone | 657-241-8601
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Fax | 714-665-4695
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Provider Business Mailing Address
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Address Line | 30492 GATEWAY PL STE 110
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City | RANCHO MISSION VIEJO
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State | CA
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Zip | 92694-1862
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A80711
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License Number State | CA
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