Provider Demographics
NPI:1184710949
Name:MCCOMB, JAMES GORDON (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:GORDON
Last Name:MCCOMB
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1300 N VERMONT AVE
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6005
Mailing Address - Country:US
Mailing Address - Phone:323-361-1800
Mailing Address - Fax:323-361-3101
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS# 102
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-1800
Practice Address - Fax:323-361-3101
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG12346207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G123460Medicaid
CA00G123460Medicaid
CAA90204Medicare UPIN