Healthcare Provider Details

I. General information

NPI: 1760473797
Provider Name (Legal Business Name): BARRY ALLAN KATZMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6945 EL CAJON BLVD
SAN DIEGO CA
92115-1754
US

IV. Provider business mailing address

6945 EL CAJON BLVD
SAN DIEGO CA
92115-1754
US

V. Phone/Fax

Practice location:
  • Phone: 619-697-4600
  • Fax: 619-464-5526
Mailing address:
  • Phone: 619-697-4600
  • Fax: 619-464-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA34834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: