Healthcare Provider Details

I. General information

NPI: 1528570009
Provider Name (Legal Business Name): DANILO BARRIENTOS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4129 GAGE AVE
BELL CA
90201
US

IV. Provider business mailing address

2550 W MAIN ST STE 301
ALHAMBRA CA
91801-7003
US

V. Phone/Fax

Practice location:
  • Phone: 323-771-8400
  • Fax:
Mailing address:
  • Phone: 626-457-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95005323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: