1649773938 NPI number — MR. RASHID BARLEY ATC,CSCS,CPT

Table of content: MR. RASHID BARLEY ATC,CSCS,CPT (NPI 1649773938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649773938 NPI number — MR. RASHID BARLEY ATC,CSCS,CPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARLEY
Provider First Name:
RASHID
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
ATC,CSCS,CPT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649773938
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
31670 FOX GRAPE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINCHESTER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92596-9503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-454-4323
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4276 54TH PL STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92115-6011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-501-5511
Provider Business Practice Location Address Fax Number:
800-507-3884
Provider Enumeration Date:
03/13/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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