Provider Demographics
NPI:1528174901
Name:MCMONAGLE, JAMES REGIS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:REGIS
Last Name:MCMONAGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4860 Y ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-3730
Mailing Address - Fax:916-734-7953
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-3730
Practice Address - Fax:916-734-7953
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31198207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G311980Medicaid
00G311980Medicare ID - Type Unspecified
A44686Medicare UPIN