Provider Demographics
NPI:1851369649
Name:BARRIE, GENE MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:MARTIN
Last Name:BARRIE
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 1:2299 MOWRY AVENUE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1621
Mailing Address - Country:US
Mailing Address - Phone:510-794-1411
Mailing Address - Fax:510-794-1570
Practice Address - Street 1:2299 MOWRY AVENUE
Practice Address - Street 2:SUITE 3A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1621
Practice Address - Country:US
Practice Address - Phone:510-794-1411
Practice Address - Fax:510-794-1570
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26722207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ02038ZOtherBLUE SHIELD
CAGR0094770Medicaid
A24931Medicare ID - Type Unspecified
CAGR0094770Medicaid