Provider Demographics
NPI:1053443457
Name:KATZEL, JAMES HERRON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HERRON
Last Name:KATZEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 JAMES STREET
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5211
Mailing Address - Country:US
Mailing Address - Phone:707-462-2491
Mailing Address - Fax:
Practice Address - Street 1:1540 JAMES STREET
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5211
Practice Address - Country:US
Practice Address - Phone:707-462-2491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE30685207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A26190Medicare UPIN