Provider Demographics
NPI:1821245820
Name:WELCH, JAMES NICHOLAS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:NICHOLAS
Last Name:WELCH
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 1:8018 LINDA ISLE LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5841
Mailing Address - Country:US
Mailing Address - Phone:571-215-2680
Mailing Address - Fax:916-734-4810
Practice Address - Street 1:4150 V ST STE 3400
Practice Address - Street 2:DEPARTMENT OF MEDICINE / SECTION OF HOSPITAL MEDICINE
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-7506
Practice Address - Fax:916-734-4810
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD037322174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00752487OtherRAILROAD MEDICARE
DC140924YT2Medicare PIN