Provider Demographics
NPI:1487702353
Name:FAIT, JAMES M (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:FAIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:MICHAEL
Other - Last Name:FAIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, APC
Mailing Address - Street 1:982 BRYCE CANYON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914
Mailing Address - Country:US
Mailing Address - Phone:760-539-6124
Mailing Address - Fax:866-453-5913
Practice Address - Street 1:28975 OLD TOWN FRONT STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590
Practice Address - Country:US
Practice Address - Phone:760-539-6124
Practice Address - Fax:866-453-5913
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65850207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA65850OtherLICENSE