| Glendale Neurological Clinic | |
|
930 W Main St Barstow CA 92311-2654 | |
| (747) 230-7436 | |
| Not Available |
| Full Name | Glendale Neurological Clinic |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 930 W Main St, Barstow, California |
| Authorized Official Name and Position | Robert Michael Hutchman (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7472156068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glendale Neurological Clinic 930 W Main St Barstow CA 92311-2654 Ph: (747) 215-6068 | Glendale Neurological Clinic 930 W Main St Barstow CA 92311-2654 Ph: (747) 230-7436 |
| NPI Number | 1720522063 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 02/25/2023 |
| Certification Date | 02/25/2023 |
| Medicare PECOS PAC ID | 8628350006 |
|---|---|
| Medicare Enrollment ID | O20170119000948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720522063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A85762 (California) | Primary |
| Provider Name | Kevin T Do |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1104078880 PECOS PAC ID: 5597656413 Enrollment ID: I20040417000253 |
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