Healthcare Provider Details
I. General information
NPI: 1205818465
Provider Name (Legal Business Name): JAMES WESTON HOLE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/15/2005
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9300 VALLEY CHILDREN'S PL FE16
MADERA CA
93636
US
IV. Provider business mailing address
9300 VALLEY CHILDREN'S PL SC05
MADERA CA
93636
US
V. Phone/Fax
- Phone: 559-353-6700
- Fax: 559-353-6710
- Phone: 559-353-5714
- Fax: 559-353-5708
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | 20A17508 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: