Provider Demographics
NPI:1689775223
Name:CLINGAN, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:CLINGAN
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7058
Practice Address - Country:US
Practice Address - Phone:916-733-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA031766OtherHEALTH NET
CAG77778OtherBLUE CROSS
CA000810342941OtherPHCS
CA1089903OtherGREAT WEST
CA1452863OtherUNITED HEALTHCARE
CA6556627OtherCIGNA
CA00G777780Medicaid
CA4062427OtherAETNA
CA44305OtherINTERPLAN
CA90028054OtherPACIFICARE
CAMCMG068500OtherWESTERN HEALTH ADVANTAGE
CA1071967OtherFIRST HEALTH
CA00G777780OtherBLUE SHIELD
CA6556627OtherCIGNA
CA00G777780Medicare ID - Type Unspecified