Individual provider Active NPI

Barbara Bridgen Victor, M.D.

  • Emergency Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1730132986
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A64519 Issued in CA
Practice address
12601 Garden Grove Blvd
Garden Grove, CA 92843-1908
Phone
(714) 537-5160
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A64519 CA Primary

Addresses

Primary practice location

12601 Garden Grove Blvd
Garden Grove, CA 92843-1908

Mailing address

2100 Powell Street
Suite 900
Emeryville, CA 94608-1803
Phone (510) 350-2658

Other identifiers 1

IdentifierTypeStateIssuer
00A645190MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A64519CAMDEmergency Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1730132986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2658",
            "fax_number": "510-879-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12601 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431908",
            "telephone_number": "714-537-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "BARBARA",
        "middle_name": "BRIDGEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A64519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A645190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.