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General NPI Number Information
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NPI Number | 1104885573
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Entity Type | Individual
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Provider Name | GREGG A BARAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 5151 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32504-8721
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Country | US
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Telephone | 850-416-7000
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Fax | 850-416-7884
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Provider Business Mailing Address
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Address Line | 2330 UTAH AVE STE 200
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4817
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Country | US
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Telephone | 813-251-5822
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Fax | 813-254-4597
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME56667
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | ME56667
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License Number State | FL
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