Provider Demographics
NPI:1104822410
Name:NAGEL, JAMES S (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:NAGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:70 DECLARATION DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4936
Mailing Address - Country:US
Mailing Address - Phone:530-893-0105
Mailing Address - Fax:530-893-0163
Practice Address - Street 1:70 DECLARATION DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4936
Practice Address - Country:US
Practice Address - Phone:530-893-0105
Practice Address - Fax:530-893-0163
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG78311207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110177391OtherMEDICARE RAILROAD #
CA00G783110Medicaid
110177391OtherMEDICARE RAILROAD #
CA00G783111Medicare PIN