Provider Demographics
NPI:1619029840
Name:BARKER, CHRISTOPHER L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:BARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 UNIVERSITY ST
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3314
Mailing Address - Country:US
Mailing Address - Phone:707-433-5494
Mailing Address - Fax:707-385-2157
Practice Address - Street 1:1381 UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3314
Practice Address - Country:US
Practice Address - Phone:707-433-5494
Practice Address - Fax:707-385-2157
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G321940Medicaid
00G321941Medicare ID - Type Unspecified
CA00G321940Medicaid