Healthcare Provider Details

I. General information

NPI: 1932316189
Provider Name (Legal Business Name): TIMOTHY DALE JAMES D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31103 RANCHO VIEJO RD # 2328
SAN JUAN CAPISTRANO CA
92675-1759
US

IV. Provider business mailing address

31103 RANCHO VIEJO RD # 2328
SAN JUAN CAPISTRANO CA
92675-1759
US

V. Phone/Fax

Practice location:
  • Phone: 909-702-3220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO59
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE2164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: