Provider Demographics
NPI:1457567489
Name:WATT, JAMES PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:WATT
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 1:850 MARINA BAY PKWY
Mailing Address - Street 2:BUILDING P
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-6403
Mailing Address - Country:US
Mailing Address - Phone:510-620-3056
Mailing Address - Fax:
Practice Address - Street 1:850 MARINA BAY PKWY
Practice Address - Street 2:BUILDING P
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-6403
Practice Address - Country:US
Practice Address - Phone:510-620-3056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72550208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics