Provider Demographics
NPI:1346440971
Name:KINCHSULAR, JAMES JOSEPH (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:KINCHSULAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3939 J ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3636
Mailing Address - Country:US
Mailing Address - Phone:916-454-3668
Mailing Address - Fax:916-454-9255
Practice Address - Street 1:3939 J ST
Practice Address - Street 2:SUITE 270
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3636
Practice Address - Country:US
Practice Address - Phone:916-454-3668
Practice Address - Fax:916-454-9255
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-22
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4913213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEK655ZMedicare PIN