Healthcare Provider Details

I. General information

NPI: 1295844314
Provider Name (Legal Business Name): ANTHONY J. BARKOVICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE # L358
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

505 PARNASSUS, L358 SUITE 625, BOX 1821
SAN FRANCISCO CA
94143-0628
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1655
  • Fax: 415-353-8593
Mailing address:
  • Phone: 415-353-2573
  • Fax: 415-353-9488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG46445
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberG46445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: