Healthcare Provider Details

I. General information

NPI: 1609886738
Provider Name (Legal Business Name): JAMES L POTH, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 CARBONERA DR
SANTA CRUZ CA
95060-1608
US

IV. Provider business mailing address

419 CARBONERA DR
SANTA CRUZ CA
95060-1608
US

V. Phone/Fax

Practice location:
  • Phone: 831-426-0607
  • Fax: 831-427-1525
Mailing address:
  • Phone: 831-426-0607
  • Fax: 831-427-1525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: JANIS HOKANSON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 831-426-0607