Provider Demographics
NPI:1528049608
Name:PRATTY, JAMES S (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:PRATTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21081 S. WESTERN AVE.
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1708
Mailing Address - Country:US
Mailing Address - Phone:310-224-5287
Mailing Address - Fax:
Practice Address - Street 1:21081 S WESTERN AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1703
Practice Address - Country:US
Practice Address - Phone:310-224-5287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA414092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85623Medicare UPIN
CAW14297Medicare ID - Type Unspecified