Provider Demographics
NPI:1265794754
Name:BARRETT, IAN J (MD)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:J
Last Name:BARRETT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:555 KNOWLES DRIVE SUITE 200
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032
Mailing Address - Country:US
Mailing Address - Phone:408-353-0203
Mailing Address - Fax:408-353-0204
Practice Address - Street 1:800 POLLARD RD STE C30
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1431
Practice Address - Country:US
Practice Address - Phone:408-353-0203
Practice Address - Fax:408-358-8692
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2023-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA147622207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN200003429Medicare PIN