Provider Demographics
NPI:1023413085
Name:BARRY, DANIEL CHRISTIAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:CHRISTIAN
Last Name:BARRY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:DOWNIEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95936-0286
Mailing Address - Country:US
Mailing Address - Phone:530-289-3298
Mailing Address - Fax:
Practice Address - Street 1:209 NEVADA STREET
Practice Address - Street 2:
Practice Address - City:DOWNIEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95935-0286
Practice Address - Country:US
Practice Address - Phone:530-289-3298
Practice Address - Fax:530-289-3159
Is Sole Proprietor?:No
Enumeration Date:2014-11-01
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA1199363A00000X
CA54430363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant