Healthcare Provider Details

I. General information

NPI: 1619931698
Provider Name (Legal Business Name): JAMES DAWSON HEFFELFINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/13/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 KERNER BLVD
SAN RAFAEL CA
94901-4840
US

IV. Provider business mailing address

3260 KERNER BLVD STE 130
SAN RAFAEL CA
94901-4840
US

V. Phone/Fax

Practice location:
  • Phone: 154-481-5004
  • Fax:
Mailing address:
  • Phone: 415-448-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberG76725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: