Provider Demographics
NPI:1972535680
Name:SON, JAMES CHAE-CHON (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHAE-CHON
Last Name:SON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1150 SCOTT BLVD STE B3
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4547
Mailing Address - Country:US
Mailing Address - Phone:408-261-7245
Mailing Address - Fax:408-261-7249
Practice Address - Street 1:1150 SCOTT BLVD STE B3
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4547
Practice Address - Country:US
Practice Address - Phone:408-261-7245
Practice Address - Fax:408-261-7249
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA055194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A551940Medicaid
CA00A551940Medicaid