Healthcare Provider Details

I. General information

NPI: 1629103007
Provider Name (Legal Business Name): JAMES B PRESTON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 12/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 E MEADOWRIDGE RD
ORANGE CA
92867-2030
US

IV. Provider business mailing address

3445 E MEADOWRIDGE RD
ORANGE CA
92867-2030
US

V. Phone/Fax

Practice location:
  • Phone: 949-768-9495
  • Fax: 949-768-8018
Mailing address:
  • Phone: 949-768-9495
  • Fax: 949-768-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberW2494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: