Healthcare Provider Details

I. General information

NPI: 1225010663
Provider Name (Legal Business Name): BARRY A MORGUELAN M.D. INC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BARRY A MORGUELAN M.D. INC.

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S ALVARADO ST #602
LOS ANGELES CA
90057-2320
US

IV. Provider business mailing address

201 S ALVARADO ST
LOS ANGELES CA
90057-2386
US

V. Phone/Fax

Practice location:
  • Phone: 213-413-5010
  • Fax: 213-413-7734
Mailing address:
  • Phone: 213-413-5010
  • Fax: 213-413-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG27009
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: