Healthcare Provider Details
I. General information
NPI: 1801357751
Provider Name (Legal Business Name): MARTIN JOSE BARRIO MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2019
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 UCLA MEDICAL PLZ STE 310
LOS ANGELES CA
90024-6999
US
IV. Provider business mailing address
5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US
V. Phone/Fax
- Phone: 310-267-7838
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A208668 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: