Dr Bart Sullivan, MD | |
115 W E St, Tehachapi, CA 93561-1607 | |
(661) 822-3241 | |
Not Available |
Full Name | Dr Bart Sullivan |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 115 W E St, Tehachapi, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316085160 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | A31288 (California) | Primary |
Entity Name | Lakeside Medical Organization A Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831426642 PECOS PAC ID: 7618005166 Enrollment ID: O20100505000015 |
Mailing Address | Practice Location Address |
---|---|
Dr Bart Sullivan, MD 1221 Snowbird Dr, Frazier Park, CA 93225-9693 Ph: (661) 245-0135 | Dr Bart Sullivan, MD 115 W E St, Tehachapi, CA 93561-1607 Ph: (661) 822-3241 |
Roy C. Peterson, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 115 West E Street, Tehachapi, CA 93581 Phone: 661-972-2874 Fax: 661-823-8106 | |
Vijay K Mohan, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 115 W E St, Tehachapi, CA 93561 Phone: 800-444-7009 | |
Fil Barrozo, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 W E St, Tehachapi, CA 93561 Phone: 661-822-3241 | |
Manuel Garrido, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 W E St, Tehachapi, CA 93561 Phone: 661-822-3241 |