Provider Demographics
NPI:1013002484
Name:BARRICKS, MICHAEL ELI (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ELI
Last Name:BARRICKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3800
Mailing Address - Country:US
Mailing Address - Phone:510-654-7752
Mailing Address - Fax:510-653-9257
Practice Address - Street 1:223 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:CA
Practice Address - Zip Code:94611-3800
Practice Address - Country:US
Practice Address - Phone:510-654-7752
Practice Address - Fax:510-653-9257
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG12588207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7348166OtherRESOURCE NUMBER