Provider Demographics
NPI:1912007758
Name:DAVID J BARNETTE JR A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:DAVID J BARNETTE JR A MEDICAL CORPORATION
Other - Org Name:DERMATOPATHOLOGY MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARNETTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:858-539-7300
Mailing Address - Street 1:PO BOX 99669
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92169-1669
Mailing Address - Country:US
Mailing Address - Phone:858-539-7300
Mailing Address - Fax:858-539-7305
Practice Address - Street 1:6649 CURLEW TERRACE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-3965
Practice Address - Country:US
Practice Address - Phone:858-539-7300
Practice Address - Fax:858-539-7305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADO5368OtherMEDICARE RAILROAD
CADO5368OtherMEDICARE RAILROAD