Provider Demographics
NPI:1063788057
Name:REA, JAMES LEE SR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEE
Last Name:REA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 SPERRY AVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7450
Mailing Address - Country:US
Mailing Address - Phone:866-815-6999
Mailing Address - Fax:
Practice Address - Street 1:2225 SPERRY AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7450
Practice Address - Country:US
Practice Address - Phone:866-815-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-24
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35070207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology