Provider Demographics
NPI:1093876617
Name:LYNCH, JAMES PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:LYNCH
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 1:590 BARKER PASS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-1725
Mailing Address - Country:US
Mailing Address - Phone:805-969-0052
Mailing Address - Fax:
Practice Address - Street 1:KUNSAN AIR BASE, KOREA
Practice Address - Street 2:PSC 2, BOX 274, APO AP
Practice Address - City:KUNSAN
Practice Address - State:KOREA
Practice Address - Zip Code:96264
Practice Address - Country:KR
Practice Address - Phone:0118263-470-4913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE48525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE89943Medicare UPIN