Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A94358 | CA |
NPI | 1013974625 |
---|---|
Provider Name | Dr. Joel Isaac Barthelow |
First Address | Chico, CA 95926-2186 |
Second Address | Chico, CA 95926-2186 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 29/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00805370 | RAILROAD MEDICARE (01) | CA |