Provider Demographics
NPI:1548455058
Name:JAMES N. EUSTERMANN, M.D., INC.
Entity type:Organization
Organization Name:JAMES N. EUSTERMANN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:EUSTERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-585-1800
Mailing Address - Street 1:1006 N DOUTY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3723
Mailing Address - Country:US
Mailing Address - Phone:559-585-1800
Mailing Address - Fax:559-585-1811
Practice Address - Street 1:1006 N DOUTY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3723
Practice Address - Country:US
Practice Address - Phone:559-585-1800
Practice Address - Fax:559-585-1811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES N. EUSTERMANN, M.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG8573208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ78388ZMedicare PIN
CAB18247Medicare UPIN