Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G84834 | CA |
Y | 208600000X | Surgeon | G84834 | CA |
NPI | 1013959915 |
---|---|
Provider Name | Linda K James |
First Address | Fort Bragg, CA 95437-5403 |
Second Address | Fort Bragg, CA 95437-5402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G55889 | (02) | CA |