Provider Demographics
NPI:1356482947
Name:MCCABE, JAMES L (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:MCCABE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 REDONDO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-5132
Mailing Address - Country:US
Mailing Address - Phone:562-987-2626
Mailing Address - Fax:
Practice Address - Street 1:915 REDONDO AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-5132
Practice Address - Country:US
Practice Address - Phone:562-987-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2093213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E20930Medicaid
CAWE2093Medicare ID - Type UnspecifiedMEDICARE PROVIDER
CA000E20930Medicaid