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
1926 W. BEVERLY BLVD., LOS ANGELES, CA 90057-2402
(213) 353-1140
(213) 607-1434
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
960001330
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G496230
MEDI-CAL LEGACY NUMBER
CA
01
—
CMM70931F
CLINIC MEDI-CAL
CA
01
—
FU754Z
PTAN
CA
01
—
GZ681Z
MEDICARE PTAN
CA
Enumeration date
12/05/2013
Last updated
07/29/2024
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