Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | C41905 | CA |
NPI | 1285600478 |
---|---|
Provider Name | Richard J Barry |
First Address | Vallejo, CA 94590-5700 |
Second Address | Davis, CA 95616-0672 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 21/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200005705 | RAILROAD MEDICARE INDIVIDUAL PTAN (01) | CA |
8277322 | (05) | CA |
E65326 | (02) | CA |