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General NPI Number Information
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NPI Number | 1932149010
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Entity Type | Individual
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Provider Name | JAMES GORDON CUSHMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 1411 E 31ST ST
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City | OAKLAND
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State | CA
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Zip | 94602-1018
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Country | US
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Telephone | 410-428-8645
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1867
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City | EL GRANADA
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State | CA
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Zip | 94018-1867
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Country | US
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Telephone | 410-428-8645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 13793-320
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | D61862
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | D61862
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License Number State | MD
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