Healthcare Provider Details

I. General information

NPI: 1083986616
Provider Name (Legal Business Name): JAMES GEORGE KORKOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CLAYTON RD SUITE 1000
CONCORD CA
94520-2100
US

IV. Provider business mailing address

2300 CLAYTON RD SUITE 1000
CONCORD CA
94520-2100
US

V. Phone/Fax

Practice location:
  • Phone: 925-785-7100
  • Fax:
Mailing address:
  • Phone: 925-785-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG67242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: