Healthcare Provider Details

I. General information

NPI: 1154959013
Provider Name (Legal Business Name): JAVIER JOSE BARRANCO-TRABI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 UNIVERSITY AVE
RIVERSIDE CA
92521-9800
US

IV. Provider business mailing address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

V. Phone/Fax

Practice location:
  • Phone: 909-475-2612
  • Fax: 909-475-5059
Mailing address:
  • Phone: 808-433-6341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-22764
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: