Healthcare Provider Details

I. General information

NPI: 1629294335
Provider Name (Legal Business Name): JAMES PATRICK MCCARTHY CCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 SOLANA DR
MOUNTAIN VIEW CA
94040-2232
US

IV. Provider business mailing address

1014 SOLANA DR
MOUNTAIN VIEW CA
94040-2232
US

V. Phone/Fax

Practice location:
  • Phone: 650-941-2589
  • Fax: 650-615-9995
Mailing address:
  • Phone: 650-941-2589
  • Fax: 650-615-9995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number870097
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: