Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 13290 | CA |
NPI | 1801916424 |
---|---|
Provider Name | Dr. James Everett Cheeley |
First Address | Colton, CA 92324-8182 |
Second Address | Colton, CA 92324-8182 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 01/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC0132900 006 | (05) | CA |
T04957 | (02) | CA |