Healthcare Provider Details
I. General information
NPI: 1790801355
Provider Name (Legal Business Name): JAMES STEPHEN ROBERT MURPHY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/22/2007
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2428 SANTA MONICA BLVD
SANTA MONICA CA
90404-2045
US
IV. Provider business mailing address
1701 E COLTER ST UNIT 414
PHOENIX AZ
85016-3363
US
V. Phone/Fax
- Phone: 310-315-1000
- Fax:
- Phone: 949-981-3044
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 40056 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085D0003X |
| Taxonomy | Diagnostic Neuroimaging (Radiology) Physician |
| License Number | A124149 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: