Healthcare Provider Details

I. General information

NPI: 1982618351
Provider Name (Legal Business Name): RALPH WILLIAM BARRON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 MILLER AVE
BERKELEY CA
94708-1516
US

IV. Provider business mailing address

1042 MILLER AVE
BERKELEY CA
94708-1516
US

V. Phone/Fax

Practice location:
  • Phone: 858-550-0979
  • Fax: --
Mailing address:
  • Phone: 858-550-0979
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG47970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: