Healthcare Provider Details

I. General information

NPI: 1902161813
Provider Name (Legal Business Name): MR. JAMES WALKER CHALMERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 07/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2844 COLOMA ST
PLACERVILLE CA
95667-4406
US

IV. Provider business mailing address

PO BOX 1666
PLACERVILLE CA
95667-1666
US

V. Phone/Fax

Practice location:
  • Phone: 530-642-1715
  • Fax: 530-642-2064
Mailing address:
  • Phone: 530-642-1715
  • Fax: 530-642-2064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number10726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: