Dr. Jim Otis
Neurology
431 30th St
Oakland
, California 94609-3304
(510) 832-6848
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About
Features
Specialties
- Neurology
Languages spoken
- English
Location
First Address
- Dr. Jim Otis
- 431 30th St
- Oakland, CA
- Zip : 94609-3304
- Phone : (510) 832-6848
Second Address
- Dr. Jim Otis
- 431 30th St
- Oakland, CA
- Zip : 94609-3304
- Phone : (510) 832-6848
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NN0400X | Neurology | 14460 | CA |
National Provider Identifier
| NPI | 1235351453 |
|---|---|
| Provider Name | Dr. Jim Otis |
| First Address | Oakland, CA 94609-3304 |
| Second Address | Oakland, CA 94609-3304 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.