Provider Demographics
NPI:1568540896
Name:HUDDLESTON, JAMES PRESTON (DPO II)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PRESTON
Last Name:HUDDLESTON
Suffix:
Gender:M
Credentials:DPO II
Other - Prefix:
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Mailing Address - Street 1:1132 E BERMUDA DUNES ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-6905
Mailing Address - Country:US
Mailing Address - Phone:909-923-7373
Mailing Address - Fax:
Practice Address - Street 1:1500 S MCDONNELL AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-5623
Practice Address - Country:US
Practice Address - Phone:323-981-4301
Practice Address - Fax:323-266-0155
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner