Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 20A8002 | CA |
NPI | 1013990613 |
---|---|
Provider Name | Joseph F Barakeh |
First Address | Walnut Creek, CA 94596-5214 |
Second Address | Walnut Creek, CA 94596-5214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 16/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX80020 | (05) | CA |
H53435 | (02) |