Provider Demographics
NPI:1457692055
Name:SVOBODA, JAMES ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:SVOBODA
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 1:1303 E HERNDON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3309
Mailing Address - Country:US
Mailing Address - Phone:559-450-3309
Mailing Address - Fax:
Practice Address - Street 1:1105 E SPRUCE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3313
Practice Address - Country:US
Practice Address - Phone:559-450-7200
Practice Address - Fax:559-450-7214
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41137208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery