Provider Demographics
NPI:1053308239
Name:TAFT, JAMES DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DANIEL
Last Name:TAFT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6399 SAN IGNACIO AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1215
Mailing Address - Country:US
Mailing Address - Phone:408-369-5620
Mailing Address - Fax:
Practice Address - Street 1:2438 N PONDEROSA DR STE C105
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-2465
Practice Address - Country:US
Practice Address - Phone:805-388-2068
Practice Address - Fax:805-484-7700
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY192431207N00000X
CA20A6512207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01840220Medicaid
NY01840220Medicaid
NY08U811Medicare ID - Type Unspecified