JAMES KELLER WORTHAM MD NPI 1528114410

NPI Information

NPI: 1528114410
Provider Name: JAMES KELLER WORTHAM, MD
Classification: General Practice - 208D00000X
Entity Type: Individual
Organization: OPTIMUM MEDICAL GROUP NORTH

PECOS Registration: Yes

Address:
1030 S GLENDALE AVE
SUITE 503
GLENDALE, CA
ZIP 91205
Phone: (818) 547-5400
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James Keller Wortham, MD is a general practice in Glendale, CA with 21 years of experience. James Keller Wortham, MD NPI is 1528114410. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

1030 S GLENDALE AVE
SUITE 503
GLENDALE, CA
ZIP 91205-612
Phone: (818) 547-5400
Fax: (818) 547-3380

The NPI 1528114410 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/25/2007 and was last updated on 11/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		A88510	CALIFORNIA	Yes
2	207R00000X	Internal Medicine		A88510	CALIFORNIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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