Healthcare Provider Details

I. General information

NPI: 1326493800
Provider Name (Legal Business Name): TYLER BARR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2016
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 BUCKS LAKE RD
QUINCY CA
95971-9599
US

IV. Provider business mailing address

3291 LOMA VISTA RD
VENTURA CA
93003-3099
US

V. Phone/Fax

Practice location:
  • Phone: 530-283-2121
  • Fax: 530-283-3541
Mailing address:
  • Phone: 805-652-6100
  • Fax: 805-652-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA156275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: