Provider Demographics
NPI:1154418622
Name:EGAN, BARBARA T (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:T
Last Name:EGAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:5725 W LAS POSITAS BLVD
Mailing Address - Street 2:#100
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4054
Mailing Address - Country:US
Mailing Address - Phone:925-734-8130
Mailing Address - Fax:925-225-9520
Practice Address - Street 1:5725 W LAS POSITAS BLVD
Practice Address - Street 2:#100
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4054
Practice Address - Country:US
Practice Address - Phone:925-734-8130
Practice Address - Fax:925-225-9520
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG74485207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G744850Medicaid
E91476Medicare UPIN
CA00G744850Medicaid