Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G31441 | CA |
N | 208000000X | Pediatrician | G31441 | CA |
NPI | 1184620411 |
---|---|
Provider Name | Dr. James Alvin Bartley |
First Address | Los Angeles, CA 90010-2814 |
Second Address | Riverside, CA 92501-4083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A01393 | (02) | CA |
G314410 | (05) | CA |