MEDICARE: BARBOUR & FLOYD MEDICAL ASSOCIATES

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7218	OTHER	CA	PROVIDER NUMBER

General Provider Information

NPI Number	:	1780713420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARBOUR & FLOYD MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	2610 INDUSTRY WAY
Second Line	:	SUITE A
City	:	LYNWOOD
State	:	CA
Zip	:	90262-4028
Country	:	US
Telephone Number	:	310-631-8004
Fax Number	:	323-905-1938

Provider Business Practice Location Address
First Line	:	2640 INDUSTRY WAY
Second Line	:	SUITE B
City	:	LYNWOOD
State	:	CA
Zip	:	90262-4000
Country	:	US
Telephone Number	:	310-627-4525
Fax Number	:	310-627-4531

Authorized Official
Title or Position	:	CO-DIRECTOR
Name	:	JACK BARBOUR
Credential	:	M.D.
Telephone Number	:	310-631-8004

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/28/2023

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