MEDICARE: DR. JAMES L KWAKO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	C37727	CA

General Provider Information

NPI Number	:	1396784567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES L KWAKO MD

Provider Business Mailing Address
First Line	:	1805 E CABRILLO BLVD
Second Line	:	SUITE D
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-2884
Country	:	US
Telephone Number	:	805-565-3959
Fax Number	:

Provider Business Practice Location Address
First Line	:	1805 E CABRILLO BLVD
Second Line	:	SUITE D
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-2884
Country	:	US
Telephone Number	:	805-565-3959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	05/12/2009

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