Healthcare Provider Details

I. General information

NPI: 1851320063
Provider Name (Legal Business Name): JAMES A RECABAREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 07/10/2022
Certification Date: 07/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S ARROYO PKWY STE 310
PASADENA CA
91105-3930
US

IV. Provider business mailing address

35 E GLENARM ST
PASADENA CA
91105-3418
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-4859
  • Fax: 626-403-0311
Mailing address:
  • Phone: 626-768-4415
  • Fax: 626-403-0311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number41049
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA41049
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: