Basic Information
Provider Information
NPI: 1083980585
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNES
FirstName: JAMES
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1225 15TH ST STE 2100
Address2:  
City: SANTA MONICA
State: CA
PostalCode: 904041101
CountryCode: US
TelephoneNumber: 3103191234
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/29/2012
LastUpdateDate: 12/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X55081AZN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207X00000XA159330CAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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