Provider Demographics
NPI:1346310695
Name:BARNEY, EUGENE JEFFREY (DPM)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:JEFFREY
Last Name:BARNEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 VALLEY CENTRE DR
Mailing Address - Street 2:705-413
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3320
Mailing Address - Country:US
Mailing Address - Phone:858-523-1766
Mailing Address - Fax:858-523-1766
Practice Address - Street 1:3830 VALLEY CENTRE DR
Practice Address - Street 2:705-413
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3320
Practice Address - Country:US
Practice Address - Phone:858-523-1766
Practice Address - Fax:858-523-1766
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1924213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11096Medicare UPIN