Provider Demographics
NPI:1912214305
Name:CHENOWETH, JAMES ALAN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:CHENOWETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2315 STOCKTON BLVD.
Mailing Address - Street 2:PSSB 2100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-734-8571
Mailing Address - Fax:916-734-7950
Practice Address - Street 1:2315 STOCKTON BLVD.
Practice Address - Street 2:PSSB 2100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-8571
Practice Address - Fax:916-734-7950
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA118716207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology