1790038479 NPI number — BARRY KATZMAN, M.D., INC., APC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790038479 NPI number — BARRY KATZMAN, M.D., INC., APC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARRY KATZMAN, M.D., INC., APC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WEST COAST EYE CARE ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790038479
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6945 EL CAJON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92115-1754
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-697-4600
Provider Business Mailing Address Fax Number:
619-464-5526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 FLETCHER PKWY
Provider Second Line Business Practice Location Address:
#112
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020-2595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-440-5400
Provider Business Practice Location Address Fax Number:
619-440-0239
Provider Enumeration Date:
10/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KATZMAN
Authorized Official First Name:
BARRY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER/MEDICAL DIRECTOR
Authorized Official Telephone Number:
619-697-4600

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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