Individual
DR. JAMES TIDWELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
9480 EL TEJADO RD, LA MESA, CA 91941-4462
(619) 696-9800
Mailing address
9480 EL TEJADO RD, LA MESA, CA 91941-4462
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G047644
CA
Other
Enumeration date
05/27/2005
Last updated
07/08/2007
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