Provider Demographics
NPI:1295859858
Name:BARASH, YONA (MD)
Entity Type:Individual
Prefix:
First Name:YONA
Middle Name:
Last Name:BARASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3043
Mailing Address - Country:US
Mailing Address - Phone:916-863-1805
Mailing Address - Fax:916-863-1806
Practice Address - Street 1:2 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3043
Practice Address - Country:US
Practice Address - Phone:916-863-1805
Practice Address - Fax:916-863-1806
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A314710208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5023716Medicaid
CA5023716Medicaid
A87570Medicare ID - Type Unspecified