Provider Demographics
NPI:1114948767
Name:JAMES, GEORGE (PT, DPT, OCS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, OCS
Mailing Address - Street 1:414 TENNESSEE ST STE F
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8152
Mailing Address - Country:US
Mailing Address - Phone:909-792-5050
Mailing Address - Fax:909-792-5051
Practice Address - Street 1:414 TENNESSEE ST STE F
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373
Practice Address - Country:US
Practice Address - Phone:909-792-5050
Practice Address - Fax:909-792-5051
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175L00000X
CAPT303572251G0304X, 2251X0800X
CAPT 30357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty