Healthcare Provider Details

I. General information

NPI: 1447626890
Provider Name (Legal Business Name): DR. JAMES DEMARCO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 WARNER AVE SUITE 201
FOUNTAIN VALLEY CA
92708-3232
US

IV. Provider business mailing address

8840 WARNER AVE SUITE 201
FOUNTAIN VALLEY CA
92708-3232
US

V. Phone/Fax

Practice location:
  • Phone: 714-848-3603
  • Fax: 714-848-3605
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberDC14902
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: