Provider Demographics
NPI:1235128919
Name:PARKER, BARBARA ANNE (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:B. ANNE
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2160 APPIAN WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2524
Mailing Address - Country:US
Mailing Address - Phone:510-724-9110
Mailing Address - Fax:916-239-3602
Practice Address - Street 1:1332 PARK ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4545
Practice Address - Country:US
Practice Address - Phone:510-523-3417
Practice Address - Fax:916-239-3614
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65116208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G651161Medicare ID - Type Unspecified
CAE59275Medicare UPIN