Healthcare Provider Details

I. General information

NPI: 1245270958
Provider Name (Legal Business Name): JAMES E LIES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 ADAMS ST SUITE 106
SAINT HELENA CA
94574-1148
US

IV. Provider business mailing address

999 ADAMS ST SUITE 106
SAINT HELENA CA
94574-1148
US

V. Phone/Fax

Practice location:
  • Phone: 707-963-4997
  • Fax: 707-963-4990
Mailing address:
  • Phone: 707-963-4997
  • Fax: 707-963-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC325250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: