Provider Demographics
NPI:1619062007
Name:BARLEY, WILLIAM POLLOCK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:POLLOCK
Last Name:BARLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1004 FOWLER WAY
Mailing Address - Street 2:SUITE #1
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:530-626-8003
Mailing Address - Fax:530-626-8082
Practice Address - Street 1:1004 FOWLER WAY
Practice Address - Street 2:SUITE #1
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667
Practice Address - Country:US
Practice Address - Phone:530-626-8003
Practice Address - Fax:530-626-8082
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG72071207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-3407141OtherTAX ID
CA00G720710OtherMEDI-CAL NUMBER
CA94-3407141OtherTAX ID
CA00G720710OtherMEDI-CAL NUMBER