Individual provider Active NPI

Herbert Joseph Barrack, C.P.O.

  • Prosthetic/Orthotic Supplier
  • La Mesa, CA
National Provider Identifier
1982848347
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
CPO1213 Issued in CA
Practice address
5360 Jackson Dr Ste 110
La Mesa, CA 91942-3012
Phone
(619) 667-7000
Fax
(619) 667-4315
NPI assigned
Apr 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X CPO1213 CA Primary

Addresses

Primary practice location

5360 Jackson Dr Ste 110
La Mesa, CA 91942-3012

Mailing address

5360 Jackson Dr Ste 110
La Mesa, CA 91942-3012
Phone (619) 667-7000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CPO1213CAMDProsthetic/Orthotic Supplier

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1982848347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 JACKSON DR STE 110",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423012",
            "telephone_number": "619-667-7000",
            "fax_number": "619-667-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 JACKSON DR STE 110",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423012",
            "telephone_number": "619-667-7000",
            "fax_number": "619-667-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRACK",
        "first_name": "HERBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "C.P.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "CPO1213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.