Provider Demographics
NPI:1548265234
Name:BARANSKI, JOEL JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:JUSTIN
Last Name:BARANSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4225 EXECUTIVE SQ STE 450
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:858-810-0000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:4060 4TH AVE
Practice Address - Street 2:STE 220
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2120
Practice Address - Country:US
Practice Address - Phone:619-299-2350
Practice Address - Fax:619-297-8379
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-06-28
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Provider Licenses
StateLicense IDTaxonomies
CAG67559207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG675590OtherSO. CALIFORNIA PTAN
CA00G675590Medicaid
CADX113YOtherNO. CALIFORNIA PTAN
CAF69760Medicare UPIN