Provider Demographics
NPI:1083722144
Name:BREAUX, BARRY E (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:E
Last Name:BREAUX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1320 TARA HILLS DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564
Mailing Address - Country:US
Mailing Address - Phone:510-724-8100
Mailing Address - Fax:510-724-9255
Practice Address - Street 1:1320 TARA HILLS DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564
Practice Address - Country:US
Practice Address - Phone:510-724-8100
Practice Address - Fax:510-724-9255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-01-08
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Provider Licenses
StateLicense IDTaxonomies
CAG34283207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A45862Medicare UPIN