Provider Demographics
NPI:1184962144
Name:PENNINGTON, JAMES EARL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EARL
Last Name:PENNINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4 TOLEDO DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2952
Mailing Address - Country:US
Mailing Address - Phone:925-899-5922
Mailing Address - Fax:925-283-7876
Practice Address - Street 1:4 TOLEDO DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-2952
Practice Address - Country:US
Practice Address - Phone:925-899-5922
Practice Address - Fax:925-283-7876
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-26
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG59543207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG59543OtherPHYSICIAN AND SURGEON