Healthcare Provider Details

I. General information

NPI: 1033117775
Provider Name (Legal Business Name): H. JAMES PRINCETON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 W CALDWELL AVE SUITE A
VISALIA CA
93277-9224
US

IV. Provider business mailing address

4025 W CALDWELL AVE SUITE A
VISALIA CA
93277-9224
US

V. Phone/Fax

Practice location:
  • Phone: 559-733-4505
  • Fax: 559-733-0876
Mailing address:
  • Phone: 559-625-6080
  • Fax: 559-625-6024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA40100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: