Provider Demographics
NPI:1033140421
Name:JAMES E DEAN M D P C
Entity Type:Organization
Organization Name:JAMES E DEAN M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:559-582-0347
Mailing Address - Street 1:1105 N DOUTY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3716
Mailing Address - Country:US
Mailing Address - Phone:559-582-0347
Mailing Address - Fax:559-582-7360
Practice Address - Street 1:1105 N DOUTY ST
Practice Address - Street 2:SUITE B
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3716
Practice Address - Country:US
Practice Address - Phone:559-582-0347
Practice Address - Fax:559-582-7360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA19472207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA21763Medicare UPIN
CAOOA194720Medicare ID - Type UnspecifiedMEDICARE NUMBER