Provider Demographics
NPI:1942226766
Name:JAWORSKI, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:JAWORSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6406
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93456-6406
Mailing Address - Country:US
Mailing Address - Phone:805-928-1731
Mailing Address - Fax:805-349-8160
Practice Address - Street 1:2705 HARRIS ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4807
Practice Address - Country:US
Practice Address - Phone:805-928-1731
Practice Address - Fax:805-349-8160
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG29480207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G294800Medicaid
CAA44049Medicare UPIN
CA00G294800Medicaid