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General NPI Number Information
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NPI Number | 1023960200
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Entity Type | Individual
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Provider Name | GARY DAVIS BARNES II SUDRC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 3200 W TEMPLE ST APT 310
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City | LOS ANGELES
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State | CA
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Zip | 90026-7374
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Country | US
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Telephone | 213-312-7669
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Fax | 213-312-7669
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Provider Business Mailing Address
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Address Line | 2330 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90057-2220
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Country | US
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Telephone | 213-312-7669
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Fax | 213-312-7669
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21913
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License Number State | CA
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