Healthcare Provider Details

I. General information

NPI: 1780659813
Provider Name (Legal Business Name): JAIME ARTURO FOLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20369 STARR KING DR
SOULSBYVILLE CA
95372-9603
US

IV. Provider business mailing address

20369 STARR KING DR
SOULSBYVILLE CA
95372-9603
US

V. Phone/Fax

Practice location:
  • Phone: 209-694-6104
  • Fax:
Mailing address:
  • Phone: 209-694-6104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME89138
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number00025663
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA51652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: