Provider Demographics
NPI:1427049204
Name:BARROWS, RANDOLPH CORBIN JR (MD, MS)
Entity type:Individual
Prefix:DR
First Name:RANDOLPH
Middle Name:CORBIN
Last Name:BARROWS
Suffix:JR
Gender:M
Credentials:MD, MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3350 LA JOLLA VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92161-0002
Mailing Address - Country:US
Mailing Address - Phone:858-552-8585
Mailing Address - Fax:858-552-7452
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:858-552-7452
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY168477207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01091318Medicaid
NY168477OtherSTATE MEDICAL LICENSE
AB2759794OtherDEA NUMBER
NY01091318Medicaid
R60 87F761 0Medicare ID - Type Unspecified