Provider Demographics
NPI:1760174882
Name:BARAYE
Entity Type:Organization
Organization Name:BARAYE
Other - Org Name:IRVINE DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARJON
Authorized Official - Middle Name:
Authorized Official - Last Name:VATANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-800-8551
Mailing Address - Street 1:6865 ALTON PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3741
Mailing Address - Country:US
Mailing Address - Phone:949-800-8551
Mailing Address - Fax:657-400-8008
Practice Address - Street 1:6865 ALTON PKWY STE 210
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3741
Practice Address - Country:US
Practice Address - Phone:949-800-8551
Practice Address - Fax:657-400-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty