Healthcare Provider Details

I. General information

NPI: 1891856068
Provider Name (Legal Business Name): ROBERT A. BARNES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 MOUND VIEW AVE.
STUDIO CITY CA
91604-3630
US

IV. Provider business mailing address

3840 MOUND VIEW AVE
STUDIO CITY CA
91604-3630
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-7747
  • Fax: 818-763-7747
Mailing address:
  • Phone: 818-763-7747
  • Fax: 818-763-7747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC25728
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: