MEDICARE: CONNIE P BARTLETT D.O.

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	208000000X	Pediatrics Physician	20A6599	CA

General Provider Information

NPI Number	:	1669561858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE P BARTLETT D.O.

Provider Business Mailing Address
First Line	:	24422 AVENIDA DE LA CARLOTA STE 300
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3628
Country	:	US
Telephone Number	:	949-599-2434
Fax Number	:	949-599-2430

Provider Business Practice Location Address
First Line	:	17742 BEACH BLVD STE 240
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6835
Country	:	US
Telephone Number	:	714-842-0444
Fax Number	:

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	01/06/2026

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