Healthcare Provider Details

I. General information

NPI: 1093126336
Provider Name (Legal Business Name): JAMES ANDREW O'DOWD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S RAYMOND AVE
PASADENA CA
91105-3229
US

IV. Provider business mailing address

1200 NORTH STATE STREET GNH 3900 ORTHOPEDIC SURGERY
LOS ANGELES CA
90033
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-8051
  • Fax:
Mailing address:
  • Phone: 323-226-7204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA138430
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberA138430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: