Provider Demographics
NPI:1922006071
Name:MCNAMARA, BARRY A (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:A
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 SOUTHGATE AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2246
Mailing Address - Country:US
Mailing Address - Phone:650-992-1300
Mailing Address - Fax:650-992-8391
Practice Address - Street 1:1440 SOUTHGATE AVE
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2246
Practice Address - Country:US
Practice Address - Phone:650-992-1300
Practice Address - Fax:650-992-8391
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24299207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ47199AOtherBLUE SHIELD GROUP #
CA013652OtherHILL PHYSICIANS #
CAGR0066060Medicaid
CA00A242995Medicare PIN
CAA23902Medicare UPIN
CAZZZ00628ZMedicare PIN
CA00A242990Medicare PIN
CAZZZ47199AOtherBLUE SHIELD GROUP #
CA180004450Medicare ID - Type UnspecifiedRR MEDICARE
CADB7796Medicare PIN
CA00A242993Medicare PIN
CA013652OtherHILL PHYSICIANS #
CAZZZ00142ZMedicare PIN