Provider Demographics
NPI:1326010620
Name:HUNT, JAMES E (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:HUNT
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 1:1140 SONOMA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4817
Mailing Address - Country:US
Mailing Address - Phone:707-838-3400
Mailing Address - Fax:855-386-7000
Practice Address - Street 1:1140 SONOMA AVE STE 2
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4817
Practice Address - Country:US
Practice Address - Phone:707-542-1225
Practice Address - Fax:855-386-7000
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78304207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4395590001OtherDMERC JURISDICTION D
CA4395590001OtherDMERC JURISDICTION D
CACA180718Medicare PIN
CA00G783042Medicare PIN
CAP00821920Medicare PIN