Provider Demographics
NPI:1982735205
Name:BRAFF, BARRY D (OD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:D
Last Name:BRAFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 987
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93032-0987
Mailing Address - Country:US
Mailing Address - Phone:805-483-3616
Mailing Address - Fax:805-483-4377
Practice Address - Street 1:435 N A ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-4903
Practice Address - Country:US
Practice Address - Phone:805-483-3616
Practice Address - Fax:805-483-4377
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4830T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOP4830Medicare PIN
CAT69956Medicare UPIN