MEDICARE: TYLER RAY BARKER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	95264421	CA
2	163WC1500X	Community Health Registered Nurse	95264421	CA

General Provider Information

NPI Number	:	1194675215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER RAY BARKER RN

Provider Business Mailing Address
First Line	:	2442 FENTON PKWY APT 216
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4799
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2017 1ST AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2033
Country	:	US
Telephone Number	:	888-743-7526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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