Provider Demographics
NPI:1053328575
Name:POTH, JAMES L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:POTH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:419 CARBONERA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1608
Mailing Address - Country:US
Mailing Address - Phone:831-426-0607
Mailing Address - Fax:831-427-1525
Practice Address - Street 1:419 CARBONERA DR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-1608
Practice Address - Country:US
Practice Address - Phone:831-426-0607
Practice Address - Fax:831-427-1525
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG142100207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A29197Medicare UPIN
00G142100Medicare ID - Type Unspecified