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General NPI Number Information
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NPI Number | 1760174882
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Entity Type | Organization
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Legal Business Name | BARAYE
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Dates
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Enumeration Date | 05/25/2023
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Last Update Date | 01/28/2024
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Provider Practice Location Address
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Address Line | 6865 ALTON PKWY STE 210
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City | IRVINE
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State | CA
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Zip | 92618-3741
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Country | US
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Telephone | 949-800-8551
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Fax | 657-400-8008
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Provider Business Mailing Address
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Address Line | 6865 ALTON PKWY STE 210
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City | IRVINE
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State | CA
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Zip | 92618-3741
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Country | US
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Telephone | 949-800-8551
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Fax | 657-400-8008
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. MARJON VATANCHI
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Credential | MD
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Telephone | 949-800-8551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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