Provider Demographics
NPI:1184680373
Name:EUSTERMANN, JAMES NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NICHOLAS
Last Name:EUSTERMANN
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 1:1006 N DOUTY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3723
Mailing Address - Country:US
Mailing Address - Phone:559-585-1800
Mailing Address - Fax:559-585-1811
Practice Address - Street 1:1006 N DOUTY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3723
Practice Address - Country:US
Practice Address - Phone:559-585-1800
Practice Address - Fax:559-585-1811
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG8573208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB18247Medicare UPIN
CAZZZ78388ZMedicare ID - Type Unspecified