Healthcare Provider Details

I. General information

NPI: 1053612333
Provider Name (Legal Business Name): E JAMES LANGHAM MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 30TH STREET #201
OAKLAND CA
94609-3235
US

IV. Provider business mailing address

491 30TH STREET #201
OAKLAND CA
94609-3235
US

V. Phone/Fax

Practice location:
  • Phone: 510-836-2122
  • Fax: 510-836-3773
Mailing address:
  • Phone: 510-836-2122
  • Fax: 510-836-3773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC29049
License Number StateCA

VIII. Authorized Official

Name: DR. ERNEST JAMES LANGHAM
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 510-836-2122