Active NPI
Marco Barahona, P.A
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1871705004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11840
- Practice address
- 4762 Whittier Blvd
Los Angeles, CA 90022-3026 - Phone
- (323) 269-4060
- Fax
- (323) 269-5284
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11840 | CA | Primary |
| Medical Physician Assistant | 363AM0700X | PA 11840 | CA |
Addresses
Primary practice location
4762 Whittier Blvd
Los Angeles, CA 90022-3026
Mailing address
17731 Seminole Way
Yorba Linda, CA 92886-5153
Phone (714) 993-9433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA11840 | CA | MD | Physician Assistant |
| PA 11840 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311811200000",
"number": "1871705004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17731 SEMINOLE WAY",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928865153",
"telephone_number": "714-993-9433",
"fax_number": "714-993-9232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4762 WHITTIER BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900223026",
"telephone_number": "323-269-4060",
"fax_number": "323-269-5284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARAHONA",
"first_name": "MARCO",
"name_prefix": "Mr.",
"credential": "P.A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2011-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA11840",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA 11840",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.