Provider Demographics
NPI:1205350345
Name:HAROLD C BARNES MD INC
Entity type:Organization
Organization Name:HAROLD C BARNES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-772-2000
Mailing Address - Street 1:PO BOX 6025
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92248-6025
Mailing Address - Country:US
Mailing Address - Phone:760-772-2000
Mailing Address - Fax:760-772-2808
Practice Address - Street 1:43576 WASHINGTON ST STE 120
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8566
Practice Address - Country:US
Practice Address - Phone:760-772-2000
Practice Address - Fax:760-772-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64256208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1487627212Medicaid