Provider Demographics
NPI:1417735739
Name:JAMES, HAYDEN SETH (IDC)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:SETH
Last Name:JAMES
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 PALM AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-1783
Mailing Address - Country:US
Mailing Address - Phone:904-993-7976
Mailing Address - Fax:
Practice Address - Street 1:312 PALM AVE APT 101
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-1783
Practice Address - Country:US
Practice Address - Phone:904-993-7976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman