Healthcare Provider Details

I. General information

NPI: 1033102074
Provider Name (Legal Business Name): CHARISH L BARRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 W PUEBLO ST
SANTA BARBARA CA
93105
US

IV. Provider business mailing address

510 W PUEBLO ST
SANTA BARBARA CA
93105-4230
US

V. Phone/Fax

Practice location:
  • Phone: 805-845-1221
  • Fax: 805-845-1224
Mailing address:
  • Phone: 805-845-1221
  • Fax: 805-845-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA72798
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: