Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3839 | CA |
Y | 222Z00000X | Podiatrist | E3839 | CA |
NPI | 1003989559 |
---|---|
Provider Name | Steven Bartis |
First Address | Los Altos, CA 94022-1408 |
Second Address | Fremont, CA 94538-2299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 20/05/2020 |