Provider Demographics
NPI:1497759948
Name:TATE, JAMES D (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:TATE
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 1:2888 EUREKA WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0210
Mailing Address - Country:US
Mailing Address - Phone:530-225-8710
Mailing Address - Fax:530-225-8720
Practice Address - Street 1:2888 EUREKA WAY
Practice Address - Street 2:STE 200
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0210
Practice Address - Country:US
Practice Address - Phone:530-225-8710
Practice Address - Fax:530-225-8720
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G271490174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G271490Medicaid
CA00G271490Medicare ID - Type Unspecified
CA00G271490Medicaid