Provider Demographics
NPI:1164611091
Name:MCFETRIDGE, JAMES WILEY (SRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILEY
Last Name:MCFETRIDGE
Suffix:
Gender:M
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 CEBU PL
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5905
Mailing Address - Country:US
Mailing Address - Phone:619-742-9887
Mailing Address - Fax:
Practice Address - Street 1:2839 CEBU PL
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-5905
Practice Address - Country:US
Practice Address - Phone:619-742-9887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital