Healthcare Provider Details

I. General information

NPI: 1487794020
Provider Name (Legal Business Name): JOHN CARTER BARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 41ST AVE
SAN FRANCISCO CA
94116-1101
US

IV. Provider business mailing address

1380 HOWARD ST 5TH FLOOR
SAN FRANCISCO CA
94103-2638
US

V. Phone/Fax

Practice location:
  • Phone: 415-753-7255
  • Fax: 415-753-0164
Mailing address:
  • Phone: 415-255-3699
  • Fax: 415-252-3015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG84024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: