Provider Demographics
NPI:1588659049
Name:MINTON, JAMES LEE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEE
Last Name:MINTON
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 1:7471 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2457
Mailing Address - Country:US
Mailing Address - Phone:559-436-4500
Mailing Address - Fax:559-436-0500
Practice Address - Street 1:2021 HERNDON AVE
Practice Address - Street 2:STE. 101
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6101
Practice Address - Country:US
Practice Address - Phone:559-797-4315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42221207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21572ZOtherPTAN FOR ALL OFFICE LOCATIONS: BAZ ALLERGY, ASTHMA & SINUS CENTER
CA00G422210Medicaid
CAGR0043790Medicaid
CAZZZ21572ZOtherPTAN FOR ALL OFFICE LOCATIONS: BAZ ALLERGY, ASTHMA & SINUS CENTER
CAA48864Medicare UPIN
CA00G422214Medicare PIN
CA080113033Medicare PIN