Healthcare Provider Details

I. General information

NPI: 1174503338
Provider Name (Legal Business Name): JAMES CLIFTON HORSPOOL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2006
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDREN'S PLACE, MB01
MADERA CA
93636
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-8761
  • Fax: 559-353-6441
Mailing address:
  • Phone: 559-353-5700
  • Fax: 559-353-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A6948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: