MEDICARE: DR. KOREN LYNN BARRETT ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	ND-10	CA

General Provider Information

NPI Number	:	1225255391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KOREN LYNN BARRETT ND

Provider Business Mailing Address
First Line	:	1831 ORANGE AVE
Second Line	:	SUITE B
City	:	COSTA MESA
State	:	CA
Zip	:	92627-2839
Country	:	US
Telephone Number	:	949-642-4324
Fax Number	:	949-600-5101

Provider Business Practice Location Address
First Line	:	1831 ORANGE AVE
Second Line	:	SUITE B
City	:	COSTA MESA
State	:	CA
Zip	:	92627-2839
Country	:	US
Telephone Number	:	949-642-4324
Fax Number	:	949-548-8233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	08/27/2008

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