Provider Demographics
NPI:1326684929
Name:JAMES JEFFREY DALEY MD
Entity Type:Organization
Organization Name:JAMES JEFFREY DALEY MD
Other - Org Name:JAMES JEFFREY DALEY MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-599-4211
Mailing Address - Street 1:PO BOX 210
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-0210
Mailing Address - Country:US
Mailing Address - Phone:209-599-4211
Mailing Address - Fax:209-599-4341
Practice Address - Street 1:521 N WILMA AVE STE A
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-9503
Practice Address - Country:US
Practice Address - Phone:209-599-4211
Practice Address - Fax:209-599-7348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty