1487627212 NPI number — MR. HAROLD CHRISTOPHER BARNES MD

Table of content: MR. HAROLD CHRISTOPHER BARNES MD (NPI 1487627212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487627212 NPI number — MR. HAROLD CHRISTOPHER BARNES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARNES
Provider First Name:
HAROLD
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARNES
Provider Other First Name:
H.
Provider Other Middle Name:
CHRISTOPHER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487627212
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
516 WEST ATEN ROAD
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
IMPERIAL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-355-7730
Provider Business Mailing Address Fax Number:
760-355-7731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1665 SOUTH IMPERIAL AVENUE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
EL CENTRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-312-5900
Provider Business Practice Location Address Fax Number:
760-772-2808
Provider Enumeration Date:
02/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  A642560 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: A64256 , 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)

  • Identifier: 00A642560 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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