Provider Demographics
NPI:1609812478
Name:LEBRON, BARBARA ANN (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:LEBRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-5301
Mailing Address - Country:US
Mailing Address - Phone:310-326-9167
Mailing Address - Fax:310-326-3386
Practice Address - Street 1:2232 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5301
Practice Address - Country:US
Practice Address - Phone:310-326-9167
Practice Address - Fax:310-326-3386
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41814207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C418140OtherBLUE SHIELD
CA00C418014Medicaid
CAE10564Medicare UPIN
CA00C418014Medicaid