MEDICARE: BARAK PERAHIA 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	208800000X	Urology Physician	13034	NV
2	208800000X	Urology Physician	A64916	CA

General Provider Information

NPI Number	:	1487643714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARAK PERAHIA MD

Provider Business Mailing Address
First Line	:	1425 VISTA LN
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89703-4644
Country	:	US
Telephone Number	:	775-883-1030
Fax Number	:	775-883-4677

Provider Business Practice Location Address
First Line	:	1425 VISTA LN
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89703-4644
Country	:	US
Telephone Number	:	775-883-1030
Fax Number	:	775-883-4677

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	07/01/2009

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Directions to “ BARAK PERAHIA MD” Practice Location

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