Provider Demographics
NPI:1609183771
Name:BELCH, JAMES ANDREW (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:BELCH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA
Mailing Address - State:CA
Mailing Address - Zip Code:93428-3023
Mailing Address - Country:US
Mailing Address - Phone:805-927-1055
Mailing Address - Fax:805-927-1701
Practice Address - Street 1:4070 WEST ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA
Practice Address - State:CA
Practice Address - Zip Code:93428-3023
Practice Address - Country:US
Practice Address - Phone:805-927-1055
Practice Address - Fax:805-927-1701
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT37017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABD107Medicare PIN