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
4920 AVALON BLVD, LOS ANGELES, CA 90011-4004
(323) 235-5035
(323) 235-2023
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
960001332
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G496230
MEDI-CAL LEGACY NUMBER
CA
01
—
CMM70932F
CLINIC MEDI-CAL
CA
01
—
FU754Z
PTAN
CA
01
—
GB595Z
MEDICARE PTAN
CA
01
—
HL290Z
PTAN
CA
Enumeration date
11/26/2013
Last updated
07/29/2024
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