MEDICARE: DR. DEL FORREST BARRETT 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	05989T	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	:	1780728279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEL FORREST BARRETT O.D.

Provider Business Mailing Address
First Line	:	PO BOX 14711
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90853-4711
Country	:	US
Telephone Number	:	323-260-7410
Fax Number	:	323-261-2486

Provider Business Practice Location Address
First Line	:	2650 E OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-2608
Country	:	US
Telephone Number	:	323-260-7410
Fax Number	:	323-261-2486

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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