Provider Demographics
NPI:1689693517
Name:JAMES, PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
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:PO BOX 12845
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92255-2845
Mailing Address - Country:US
Mailing Address - Phone:760-836-9066
Mailing Address - Fax:760-836-9077
Practice Address - Street 1:36921 COOK ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6070
Practice Address - Country:US
Practice Address - Phone:760-836-9066
Practice Address - Fax:760-836-9077
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34409207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G344090Medicaid
C46480Medicare UPIN
00G344090Medicare ID - Type Unspecified