Provider Demographics
NPI:1609838994
Name:MCCALLUM, JAMES D (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:MCCALLUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-824-5335
Mailing Address - Fax:858-964-3131
Practice Address - Street 1:9898 GENESEE AVE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1205
Practice Address - Country:US
Practice Address - Phone:858-824-5335
Practice Address - Fax:858-964-3131
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA55708207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A557080Medicaid
460003655OtherRAILROAD MEDICARE
CA00A557080Medicaid
CAWA55708AMedicare ID - Type UnspecifiedGROUP# W7168
F220OtherCHAMPUS