MEDICARE: SANDRA CHRISTINE SHORT-BARTLETT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	A043133	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164464558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA CHRISTINE SHORT-BARTLETT MD

Provider Business Mailing Address
First Line	:	3440 E LA PALMA AVE
Second Line	:	NEONATAL ICU
City	:	ANAHEIM
State	:	CA
Zip	:	92806-2020
Country	:	US
Telephone Number	:	714-644-7040
Fax Number	:	714-644-7065

Provider Business Practice Location Address
First Line	:	3440 E LA PALMA AVE
Second Line	:	NEONATAL ICU
City	:	ANAHEIM
State	:	CA
Zip	:	92806-2020
Country	:	US
Telephone Number	:	714-644-7040
Fax Number	:	714-644-7065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	12/01/2021

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