Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 1595 | TX |
NPI | 1174971766 |
---|---|
Provider Name | Dr. Bethany A Barnes |
First Address | Los Angeles, CA 90066-8254 |
Second Address | Los Angeles, CA 90048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2016 |
Last Update Date | 01/08/2016 |