MEDICARE: JAMES PATRICK WATT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	G72550	CA

General Provider Information

NPI Number	:	1457567489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES PATRICK WATT M.D.

Provider Business Mailing Address
First Line	:	850 MARINA BAY PKWY
Second Line	:	BUILDING P
City	:	RICHMOND
State	:	CA
Zip	:	94804-6403
Country	:	US
Telephone Number	:	510-620-3056
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 MARINA BAY PKWY
Second Line	:	BUILDING P
City	:	RICHMOND
State	:	CA
Zip	:	94804-6403
Country	:	US
Telephone Number	:	510-620-3056
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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