Provider Demographics
NPI:1578544136
Name:BRANDT, JAMES DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:BRANDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4860 Y ST STE 2400
Mailing Address - Street 2:UC DAVIS MEDICAL CENTER - OPHTHALMOLOGY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-6818
Mailing Address - Fax:916-734-0411
Practice Address - Street 1:4860 Y ST STE 2400
Practice Address - Street 2:UC DAVIS MEDICAL CENTER - OPHTHALMOLOGY
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-6818
Practice Address - Fax:916-734-0411
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG054094207W00000X
PAMD-041308E207W00000X
MA51273207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G540940Medicare PIN
CAB74269Medicare UPIN