Provider Demographics
NPI:1992700603
Name:BARBA, DOLORES (MD)
Entity type:Individual
Prefix:DR
First Name:DOLORES
Middle Name:
Last Name:BARBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 RUBIO ST
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2052
Mailing Address - Country:US
Mailing Address - Phone:626-798-3397
Mailing Address - Fax:
Practice Address - Street 1:8311 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3928
Practice Address - Country:US
Practice Address - Phone:562-923-4911
Practice Address - Fax:562-190-4206
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A460410OtherMEDI CAL #
CAA46041Medicare UPIN