Provider Demographics
NPI:1194892794
Name:BARLAY, BRIAN (LAC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:BARLAY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 41ST ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2653
Mailing Address - Country:US
Mailing Address - Phone:510-654-7040
Mailing Address - Fax:510-654-7054
Practice Address - Street 1:330 41ST ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2653
Practice Address - Country:US
Practice Address - Phone:510-654-7040
Practice Address - Fax:510-654-7054
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4444171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist