Healthcare Provider Details
I. General information
NPI: 1043741473
Provider Name (Legal Business Name): KEVIN ANDREW BARKLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/27/2017
Last Update Date: 01/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3291 LOMA VISTA RD
VENTURA CA
93003
US
IV. Provider business mailing address
3418 LOMA VISTA RD SUITE A
VENTURA CA
93003
US
V. Phone/Fax
- Phone: 805-642-8565
- Fax: 805-642-8564
- Phone: 805-642-8565
- Fax: 805-642-8564
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | A172691 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: