Pedersen, Barton Milo
Pedersen, Barton Milo is an individual health care provider with primary practice located at 56970 Yucca Trl , Yucca Valley CA 92284-3753. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Pedersen, Barton Milo can be contacted via phone (760) 228-2020.Contact Information
Primary practice address
56970 Yucca Trl
Yucca Valley CA 92284-3753
Phone: (760) 228-2020
Fax: (760) 369-2020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OPT4600T | California |
Profile Details
| NPI number | 1336123686 |
|---|---|
| LBN Legal business name | Pedersen, Barton Milo |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2005 |
| Last updated | Mar 2nd, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336123686 | NPPES |
| California | MEDICAID | SD0046000 | |
| California | Other | 1124224589 | |
| California | Other | 410004661 | |
| California | Other | 0313520001 | |
| California | Other | GSD004460 | |
| California | Other | ZZZ24908Z |
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