Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A79573 | CA |
NPI | 1013015486 |
---|---|
Provider Name | Dr. Deloris Yvette Barnes |
First Address | Cerritos, CA 90703-3969 |
Second Address | El Centro, CA 92243-4306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 10/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A795730 | (05) | CA |