Healthcare Provider Details

I. General information

NPI: 1982109286
Provider Name (Legal Business Name): ALICE PRIMROSE BARR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 2500
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

1135 JANEY WAY
SACRAMENTO CA
95819-4223
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number179650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: