Provider Demographics
NPI:1710297221
Name:PHILIP BARNETT, M.D., INC.
Entity Type:Organization
Organization Name:PHILIP BARNETT, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-828-5641
Mailing Address - Street 1:8616 LA TIJERA BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3946
Mailing Address - Country:US
Mailing Address - Phone:310-417-9063
Mailing Address - Fax:866-295-8001
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 268W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2112
Practice Address - Country:US
Practice Address - Phone:310-828-5641
Practice Address - Fax:310-828-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66800207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty