| Barstow Family Care | |
|
705 E Virginia Way Suite F Barstow CA 92311-3978 | |
| (760) 256-1227 | |
| (760) 256-1239 |
| Full Name | Barstow Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 705 E Virginia Way, Barstow, California |
| Authorized Official Name and Position | Jessica Basa (C.E.O.) |
| Authorized Official Contact | 7602561227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barstow Family Care 705 E Virginia Way Suite F Barstow CA 92311-3978 Ph: (760) 256-1227 | Barstow Family Care 705 E Virginia Way Suite F Barstow CA 92311-3978 Ph: (760) 256-1227 |
| NPI Number | 1194844597 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 06/29/2010 |
| Medicare PECOS PAC ID | 0446153159 |
|---|---|
| Medicare Enrollment ID | O20040129001198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194844597 | NPI | - | NPPES |
| DP3351 | Other | RAILROAD MEDICARE | |
| ZZZ54503Z | Other | BLUE SHIELD CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A053608 (California) | Primary |
| Provider Name | Mehul S Sonawala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336166180 PECOS PAC ID: 1658473848 Enrollment ID: I20070219000231 |
| Provider Name | Jessica V Basa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952360539 PECOS PAC ID: 4981507696 Enrollment ID: I20090803000142 |
| Provider Name | Carol Elizabeth Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447378757 PECOS PAC ID: 2668654203 Enrollment ID: I20200305002245 |
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