Healthcare Provider Details

I. General information

NPI: 1487694014
Provider Name (Legal Business Name): BRIAN C BARBICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR
SAN DIEGO CA
92134-6306
US

IV. Provider business mailing address

26732 CROWN VALLEY PKWY SUITE 351
MISSION VIEJO CA
92691-6306
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7575
  • Fax:
Mailing address:
  • Phone: 949-364-1007
  • Fax: 949-364-6057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA90159
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: