Healthcare Provider Details

I. General information

NPI: 1134122690
Provider Name (Legal Business Name): JAMES F. YUSUF Q. ERSKINE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1346 HIGH SCHOOL RD
SEBASTOPOL CA
95472-2621
US

IV. Provider business mailing address

1346 HIGH SCHOOL RD
SEBASTOPOL CA
95472-2621
US

V. Phone/Fax

Practice location:
  • Phone: 707-824-8683
  • Fax: 707-824-9235
Mailing address:
  • Phone: 707-829-5455
  • Fax: 707-824-9235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number20A5942
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A5942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: