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NPI Code Detail

MEDICARE: JAMES C STOODY M. D.

MEDICARE:   JAMES C STOODY  M. D.
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
12084N0400XNeurology PhysicianC404066CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407833692
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES C STOODY M. D.
Provider Business Mailing Address
First Line : 2 MEDICAL PLAZA DR
Second Line : SUITE 260
City : ROSEVILLE
State : CA
Zip : 95661-3043
Country : US
Telephone Number : 916-783-7515
Fax Number : 916-783-8095
Provider Business Practice Location Address
First Line : 2 MEDICAL PLAZA DR
Second Line : SUITE 260
City : ROSEVILLE
State : CA
Zip : 95661-3043
Country : US
Telephone Number : 916-783-7515
Fax Number : 916-783-8095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 07/08/2007

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