Provider Demographics
NPI:1851539555
Name:BARAJAS, ALBERT (BA)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:BARAJAS
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3048 HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-4812
Mailing Address - Country:US
Mailing Address - Phone:626-372-0658
Mailing Address - Fax:
Practice Address - Street 1:6736 LAUREL CANYON BLVD
Practice Address - Street 2:SUITE:200
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1538
Practice Address - Country:US
Practice Address - Phone:818-755-8786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner