Provider Demographics
NPI:1760645121
Name:KAO, JAMES CHIMING (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CHIMING
Last Name:KAO
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 1:28078 BAXTER RD
Mailing Address - Street 2:SUITE 530
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-1402
Mailing Address - Country:US
Mailing Address - Phone:951-566-5229
Mailing Address - Fax:
Practice Address - Street 1:28078 BAXTER RD
Practice Address - Street 2:SUITE 530
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1402
Practice Address - Country:US
Practice Address - Phone:951-566-5229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113337207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ13239ZMedicare PIN
CADX790ZMedicare PIN