Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A681360 | CA |
N | 207PP0204X | Pediatric Emergency Physician | A681360 | CA |
NPI | 1548222961 |
---|---|
Provider Name | Celina Barba - Simic |
First Address | Oklahoma City, OK 73134-1785 |
Second Address | Burbank, CA 91505-4809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 11/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A681360 | (05) | CA |
00A681360 | BLUE SHIELD (01) | |
A68136 | BLUE CROSS (01) | |
H17947 | (02) | |
P00145680 | RAILROAD MEDICARE (01) |