Provider Demographics
NPI:1437131067
Name:BARAKAT, GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:BARAKAT
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 1:555 ASH ST
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-3711
Mailing Address - Country:US
Mailing Address - Phone:530-257-9060
Mailing Address - Fax:530-257-9384
Practice Address - Street 1:555 ASH ST
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-3711
Practice Address - Country:US
Practice Address - Phone:530-257-9060
Practice Address - Fax:530-257-9384
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42411207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G424110Medicaid
CA00G424110Medicaid
CAA48951Medicare UPIN
CA00G424110Medicare PIN