Provider Demographics
NPI:1508945940
Name:HOLMES, JAMES HENRY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HENRY
Last Name:HOLMES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4540 ARCHERDALE RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:CA
Mailing Address - Zip Code:95236-9750
Mailing Address - Country:US
Mailing Address - Phone:209-887-3188
Mailing Address - Fax:209-887-3188
Practice Address - Street 1:1502 ST. MARK'S PLAZA
Practice Address - Street 2:SUITE 5
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6409
Practice Address - Country:US
Practice Address - Phone:209-466-8683
Practice Address - Fax:209-466-8309
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG30996207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0G309960Medicaid
CABHO285331OtherDEA NUMBER
CAA44629Medicare UPIN
CA0G309960Medicare ID - Type Unspecified