Provider Demographics
NPI:1316048366
Name:LINDBERG, JAMES CHARLES SR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHARLES
Last Name:LINDBERG
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 1:33 CREEK RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4791
Mailing Address - Country:US
Mailing Address - Phone:949-262-3031
Mailing Address - Fax:
Practice Address - Street 1:33 CREEK RD
Practice Address - Street 2:SUITE 190
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4791
Practice Address - Country:US
Practice Address - Phone:949-262-3031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGO59887207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE51146Medicare UPIN