MEDICARE: RICHARD J BARRY M.D.

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	C41905	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	200005705	OTHER	CA	RAILROAD MEDICARE INDIVIDUAL PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285600478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD J BARRY M.D.

Provider Business Mailing Address
First Line	:	365 TUOLUMNE ST
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94590-5700
Country	:	US
Telephone Number	:	707-553-5044
Fax Number	:

Provider Business Practice Location Address
First Line	:	2031 ANDERSON RD
Second Line	:	STE A
City	:	DAVIS
State	:	CA
Zip	:	95616-0672
Country	:	US
Telephone Number	:	530-757-3700
Fax Number	:	530-756-6907

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	02/21/2013

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