Provider Demographics
NPI:1790223188
Name:BARKER, CRAIG DOUGLAS (PHARMD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:DOUGLAS
Last Name:BARKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 VINTAGE CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2510
Mailing Address - Country:US
Mailing Address - Phone:714-390-0364
Mailing Address - Fax:
Practice Address - Street 1:7720 LORRAINE AVE
Practice Address - Street 2:#102
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-4203
Practice Address - Country:US
Practice Address - Phone:209-957-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist