Provider Demographics
NPI:1639391170
Name:BARNETT, FARRELL C (MD)
Entity Type:Individual
Prefix:MR
First Name:FARRELL
Middle Name:C
Last Name:BARNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 LAKESIDE DRIVE
Mailing Address - Street 2:602
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3503
Mailing Address - Country:US
Mailing Address - Phone:510-839-7918
Mailing Address - Fax:510-839-7918
Practice Address - Street 1:6955 FOOTHILL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2409
Practice Address - Country:US
Practice Address - Phone:510-304-6045
Practice Address - Fax:510-839-7918
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC050042207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine