Healthcare Provider Details

I. General information

NPI: 1700071545
Provider Name (Legal Business Name): JAMES BRIAN WARNE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 12/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 SAMARITAN DR STE 750
SAN JOSE CA
95124-4109
US

IV. Provider business mailing address

PO BOX 320838
LOS GATOS CA
95032-0113
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-1833
  • Fax: 408-356-5753
Mailing address:
  • Phone: 408-358-1833
  • Fax: 408-356-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE3687
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: