MEDICARE: CHAROLETTE A BARNES-LEBLANC O.D.

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	152W00000X	Optometrist	8665T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689785651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAROLETTE A BARNES-LEBLANC O.D.

Provider Business Mailing Address
First Line	:	29314 BIRDY CT
Second Line	:
City	:	NUEVO
State	:	CA
Zip	:	92567-9493
Country	:	US
Telephone Number	:	951-940-8100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1688 N PERRIS BLVD
Second Line	:	STE L5
City	:	PERRIS
State	:	CA
Zip	:	92571-4709
Country	:	US
Telephone Number	:	951-940-8100
Fax Number	:	951-940-0780

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	09/22/2017

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Directions to “ CHAROLETTE A BARNES-LEBLANC O.D.” Practice Location

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