Provider Demographics
NPI:1306916408
Name:KIRN, JAMES P (BS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:P
Last Name:KIRN
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Gender:M
Credentials:BS
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Mailing Address - Street 1:40 RAGSDALE DR
Mailing Address - Street 2:STE-120
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5790
Mailing Address - Country:US
Mailing Address - Phone:831-655-3580
Mailing Address - Fax:831-655-3501
Practice Address - Street 1:40 RAGSDALE DR
Practice Address - Street 2:STE-120
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5790
Practice Address - Country:US
Practice Address - Phone:831-655-3580
Practice Address - Fax:831-655-3501
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2009-02-12
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Provider Licenses
StateLicense IDTaxonomies
CA1004781744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXC0007762Medicaid
CA5297990001Medicare NSC