Provider Demographics
NPI:1811704638
Name:BARAHONA COFFIN, OSCAR ALEJANDRO (NP)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:ALEJANDRO
Last Name:BARAHONA COFFIN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21535 ROSCOE BLVD APT 315
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4194
Mailing Address - Country:US
Mailing Address - Phone:626-267-3325
Mailing Address - Fax:
Practice Address - Street 1:10690 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-2620
Practice Address - Country:US
Practice Address - Phone:626-267-3325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty