=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598836355
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VICTORIA REGINA BARRIO M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2006
-----------------------------------------------------
Last Update Date | 09/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15725 POMERADO RD STE 102
-----------------------------------------------------
City | POWAY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92064-2057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-267-8303
-----------------------------------------------------
Fax | 619-267-4835
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3860 CALLE FORTUNADA SUITE 210
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92123-4800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-309-6303
-----------------------------------------------------
Fax | 858-309-6301
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number | A91617
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207NP0225X
-----------------------------------------------------
Taxonomy Name | Pediatric Dermatology Physician
-----------------------------------------------------
License Number | A91617
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------