Individual
DR. JEROME A. BARAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 VAN NESS AVE FL 3, SAN FRANCISCO, CA 94109-6919
(415) 600-3232
(415) 447-6335
Mailing address
PO BOX 6102, NOVATO, CA 94948-6102
(415) 884-9125
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
G63097
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G63097
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G630970
—
CA
01
—
300130264
RAILROAD MEDICARE
CA
Enumeration date
05/24/2006
Last updated
03/21/2024
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