James Michael Medeiros, D.O.
Individual provider Active NPI Preventive Medicine/Occupational Environmental Medicine Physician · Edwards Afb, CA
NPI 1831486554 · NPPES record last updated Mar 25, 2023
Key facts
- NPI
- 1831486554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X
- License
- OS016249 (PA)
- Practice address
- 30 Nightingale Rd BLDG 5525
Edwards Afb, CA 93524-0001 - Phone
- (661) 275-2750
- NPI assigned
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS016249 | PA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | OS016249 | PA | |
| General Practice Physician | 208D00000X | OS016249 | PA | |
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | OS016249 | PA | Yes |
Addresses
Primary practice location
30 Nightingale Rd BLDG 5525
Edwards Afb, CA 93524-0001
Mailing address
30 Nightingale Rd BLDG 5525
Edwards Afb, CA 93524-0001
Phone (661) 275-2750
Other providers in Edwards Afb, CA
- Jun Kyung Ko
- Melanie Lamb
- Daniel R Lamothe
- Jesse Lee
- Patricia Ann Macsparran
- Dawn Michaela Morales
- Kayla Cristina Mowatt Diamreyan
- Robert Naemura
- National Vision, Inc.
- Josephine Nguyen
All providers in Edwards Afb, CA · Preventive Medicine/Occupational Environmental Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.