1548222961 NPI number — CELINA BARBA - SIMIC M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548222961 NPI number — CELINA BARBA - SIMIC M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARBA - SIMIC
Provider First Name:
CELINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARBA
Provider Other First Name:
CELINA
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548222961
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 W MEMORIAL RD
Provider Second Line Business Mailing Address:
SUITE 121
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73134-1785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-749-4560
Provider Business Mailing Address Fax Number:
405-751-3183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 S BUENA VISTA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURBANK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91505-4809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-843-5111
Provider Business Practice Location Address Fax Number:
405-751-3183
Provider Enumeration Date:
04/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  A681360 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207PP0204X , with the licence number: A681360 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00145680 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00A681360 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00A681360 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: A68136 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".




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