Provider Demographics
NPI:1851320063
Name:RECABAREN, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:RECABAREN
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 1:35 E GLENARM ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3418
Mailing Address - Country:US
Mailing Address - Phone:626-768-4415
Mailing Address - Fax:626-403-0311
Practice Address - Street 1:950 S ARROYO PKWY STE 310
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3930
Practice Address - Country:US
Practice Address - Phone:626-449-4859
Practice Address - Fax:626-403-0311
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410492086X0206X
CAA41049208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41049OtherCA MEDICAL BOARD
CA020037909OtherMEDICARE RAILROAD PIN
CA020037909OtherMEDICARE RAILROAD PIN
CAA29284Medicare UPIN
CABM482ZMedicare PIN
CA00A410490Medicaid