Basic Information
Provider Information
NPI: 1790704476
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CANFIELD
FirstName: JAMES
MiddleName:  
NamePrefix: MR.
NameSuffix: JR.
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3438 EDGEWATER PL
Address2:  
City: VALLEJO
State: CA
PostalCode: 945918397
CountryCode: US
TelephoneNumber: 7076471953
FaxNumber:  
Practice Location
Address1: 3801 MIRANDA AVE
Address2: MAILCODE 111P
City: PALO ALTO
State: CA
PostalCode: 943041207
CountryCode: US
TelephoneNumber: 6504935000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/19/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225B00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function Technologist 

No ID Information.


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