Provider Demographics
NPI:1033117775
Name:PRINCETON, H. JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:H.
Middle Name:JAMES
Last Name:PRINCETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4025 W CALDWELL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9224
Mailing Address - Country:US
Mailing Address - Phone:559-625-6080
Mailing Address - Fax:559-625-6024
Practice Address - Street 1:4025 W CALDWELL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-9224
Practice Address - Country:US
Practice Address - Phone:559-733-4505
Practice Address - Fax:559-733-0876
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A40100Medicaid
CA00A40100Medicaid
A29046Medicare UPIN