Provider Demographics
NPI:1750305777
Name:MARGOLIS, JAMES A (MD0)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:MARGOLIS
Suffix:
Gender:M
Credentials:MD0
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 HOWE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3912
Mailing Address - Country:US
Mailing Address - Phone:916-929-0808
Mailing Address - Fax:916-649-8657
Practice Address - Street 1:855 HOWE AVE STE 1
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3912
Practice Address - Country:US
Practice Address - Phone:916-929-0808
Practice Address - Fax:916-649-8657
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG165022084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23857Medicaid
AM4481557OtherFEDERAL NARCOTICS LICENSE
CAG16502OtherSTATE MEDICAL LICENSE
CAG16502OtherSTATE MEDICAL LICENSE