Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD 60340741 | WA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | G75308 | CA |
NPI | 1326010257 |
---|---|
Provider Name | Dr. James Frederic Brinkman |
First Address | Oceanside, CA 92052-5882 |
Second Address | Oceanside, CA 92057-5727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2006 |
Last Update Date | 21/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G753080 | (05) | CA |
00G753080 | BLUE CROSS/BLUE SHIELD # (01) | CA |
080187111 | RAILROAD MEDICARE # (01) | CA |
1326010257 | INDIVIDUAL NPI # (01) | CA |
A17274 | (02) | CA |
BB3224677 | DEA # (01) | CA |
G75308 | STATE MEDICAL LICENSE (01) | CA |
MD 60340741 | WA STATE MEDICAL LICENSE (01) | WA |
WG75308Q | MEDICARE PPIN # (01) | CA |