Healthcare Provider Details

I. General information

NPI: 1881665958
Provider Name (Legal Business Name): JAMES E. SWEETLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10641 MOUNTAIN OAK CT
JAMESTOWN CA
95327-9247
US

IV. Provider business mailing address

10641 MOUNTAIN OAK CT
JAMESTOWN CA
95327-9247
US

V. Phone/Fax

Practice location:
  • Phone: 209-984-5550
  • Fax: 209-984-5559
Mailing address:
  • Phone: 209-984-5550
  • Fax: 209-984-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG45417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: