Healthcare Provider Details

I. General information

NPI: 1831250729
Provider Name (Legal Business Name): TAMRA LEE BARKER M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 3RD ST # 73381
DAVIS CA
95616-4519
US

IV. Provider business mailing address

424 3RD ST # 73381
DAVIS CA
95616-4519
US

V. Phone/Fax

Practice location:
  • Phone: 650-388-0528
  • Fax:
Mailing address:
  • Phone: 650-388-0528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA61346
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: