James J. Glynn, M.D. a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

G22422 Issued in CA

Legal business name

JAMES J. GLYNN, M.D. A MEDICAL CORPORATION

Practice address

1496 Professional Dr
Suite 601
Petaluma, CA 94954-6698

Phone

(707) 778-1131

Fax

(707) 778-3818

NPI assigned

Jan 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mimi J Newcomer

Title

Office Manager

Phone

(707) 778-1131

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1770768657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1496 PROFESSIONAL DR",
            "address_2": "SUITE 601",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546698",
            "telephone_number": "707-778-1131",
            "fax_number": "707-778-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 PROFESSIONAL DR",
            "address_2": "SUITE 601",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546698",
            "telephone_number": "707-778-1131",
            "fax_number": "707-778-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES J. GLYNN, M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "NEWCOMER",
        "authorized_official_first_name": "MIMI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "707-778-1131",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G22422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770768657",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DL686A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Jackson, PT
• Janette S Jacobs
• Lina Jadid, PHARMD
• Marilyn Lee Jaffe
• John Jahrling
• Le Ann James, CNM
• Margie Rose Jamin, MFT
• Jillian Marie Janisen, ASW
• Hanna Jansson, PA-C
• David Jaramillo Jr.

• Specialist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.