MEDICARE: IAN J BARRETT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	A147622	CA

General Provider Information

NPI Number	:	1265794754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IAN J BARRETT MD

Provider Business Mailing Address
First Line	:	555 KNOWLES DRIVE SUITE 200
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032
Country	:	US
Telephone Number	:	408-353-0203
Fax Number	:	408-353-0204

Provider Business Practice Location Address
First Line	:	800 POLLARD RD STE C30
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-1431
Country	:	US
Telephone Number	:	408-353-0203
Fax Number	:	408-358-8692

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2012
Last Update Date	:	04/11/2023

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