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NPI Code Detail

MEDICARE: DR. IVAN STEPHEN BAROYA M.D.

MEDICARE: DR. IVAN STEPHEN BAROYA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianA66801CA

General Provider Information

NPI Number : 1417990243
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IVAN STEPHEN BAROYA M.D.
Provider Business Mailing Address
First Line : PO BOX 1770
Second Line :
City : LA MESA
State : CA
Zip : 91944-1770
Country : US
Telephone Number : 619-622-6916
Fax Number : 951-303-6588
Provider Business Practice Location Address
First Line : 11858 BERNARDO PLAZA CT STE 210
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-2411
Country : US
Telephone Number : 619-622-6916
Fax Number : 951-303-6588
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 03/08/2019

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