Provider Demographics
NPI:1104525773
Name:BARRANCO TRABI MD LLC
Entity type:Organization
Organization Name:BARRANCO TRABI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:BARRANCO-TRABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-708-0158
Mailing Address - Street 1:249 LILIUOKALANI AVE APT 403
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3522
Mailing Address - Country:US
Mailing Address - Phone:210-708-0158
Mailing Address - Fax:
Practice Address - Street 1:249 LILIUOKALANI AVE APT 403
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3522
Practice Address - Country:US
Practice Address - Phone:210-708-0158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty