Provider Demographics
NPI:1417990243
Name:BAROYA, IVAN STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:STEPHEN
Last Name:BAROYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944-1770
Mailing Address - Country:US
Mailing Address - Phone:619-622-6916
Mailing Address - Fax:951-303-6588
Practice Address - Street 1:11858 BERNARDO PLAZA CT STE 210
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2411
Practice Address - Country:US
Practice Address - Phone:619-622-6916
Practice Address - Fax:951-303-6588
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA668012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry