Individual
DR. JAMES ANTHONY LOUISELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1595 SOQUEL DR STE 230, SANTA CRUZ, CA 95065-1721
(831) 226-3225
(831) 423-7579
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD182328
OR
207RP1001X
Pulmonary Disease Physician
Primary
A124140
CA
207RP1001X
Pulmonary Disease Physician
MD182328
OR
Other
Enumeration date
06/21/2012
Last updated
07/30/2019
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