Provider Demographics
NPI:1992802979
Name:BARNEY, GLENN J (DC, QME)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:J
Last Name:BARNEY
Suffix:
Gender:M
Credentials:DC, QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 NEVADA ST
Mailing Address - Street 2:SUITE #10
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4617
Mailing Address - Country:US
Mailing Address - Phone:530-887-2150
Mailing Address - Fax:530-887-2155
Practice Address - Street 1:259 NEVADA STREET
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-887-2150
Practice Address - Fax:530-887-2155
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC218820111N00000X
CADC21882111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA680441279OtherTAX ID #
CA680441279OtherTAX ID #