Healthcare Provider Details

I. General information

NPI: 1528864857
Provider Name (Legal Business Name): MIGUEL E BARRANCO-ORIGEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST # 22134
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

1411 E 31ST ST # 22134 2ND FLOOR A2
OAKLAND CA
94602-1018
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-4401
  • Fax:
Mailing address:
  • Phone: 510-437-4401
  • Fax: 510-535-7313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: