Provider Demographics
NPI:1831201920
Name:SLUSHER, JAMES A (PAC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:SLUSHER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13711 SMOKESTONE ST
Mailing Address - Street 2:SUITE 6100
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-2079
Mailing Address - Country:US
Mailing Address - Phone:909-346-8259
Mailing Address - Fax:
Practice Address - Street 1:1711 W TEMPLE ST
Practice Address - Street 2:SUITE 6100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5421
Practice Address - Country:US
Practice Address - Phone:213-483-3991
Practice Address - Fax:213-483-8287
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14117363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA970018276OtherRAILROAD MEDICARE
CAWPA14117BMedicare ID - Type Unspecified
S49623Medicare UPIN
CAWPA14117HMedicare ID - Type Unspecified
CAWPA14117JMedicare ID - Type Unspecified
CA970018276OtherRAILROAD MEDICARE