Healthcare Provider Details

I. General information

NPI: 1316260953
Provider Name (Legal Business Name): DANIEL BARRETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR BARRETT PLASTIC SURGERY PC

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 WILSHIRE BLVD STE ML1
BEVERLY HILLS CA
90212
US

IV. Provider business mailing address

9701 WILSHIRE BLVD STE ML1
BEVERLY HILLS CA
90212-2020
US

V. Phone/Fax

Practice location:
  • Phone: 310-598-2648
  • Fax:
Mailing address:
  • Phone: 310-598-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA110166
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: