Organization
BAART COMMUNITY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE JARVIE (VP, TREASURER)
(214) 379-3300
Entity
Organization
Contact information
Practice address
11315 S. ATLANTIC BLVD., LYNWOOD, CA 90262
(310) 537-5883
(310) 537-5587
Mailing address
1720 LAKEPOINTE DR STE 117, LEWISVILLE, TX 75057-6425
(214) 379-3300
(214) 853-9018
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
550000301
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C427750
MEDI-CAL LEGACY NUMBER
CA
01
—
CMM71155F
CLINIC MEDI-CAL
CA
01
—
E36084
PTAN
CA
01
—
GB929Y
MEDICARE PTAN
CA
Enumeration date
12/05/2013
Last updated
07/29/2024
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