Provider Demographics
NPI:1053612333
Name:E JAMES LANGHAM MD INC
Entity type:Organization
Organization Name:E JAMES LANGHAM MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LANGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-836-2122
Mailing Address - Street 1:491 30TH STREET
Mailing Address - Street 2:#201
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3235
Mailing Address - Country:US
Mailing Address - Phone:510-836-2122
Mailing Address - Fax:510-836-3773
Practice Address - Street 1:491 30TH STREET
Practice Address - Street 2:#201
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3235
Practice Address - Country:US
Practice Address - Phone:510-836-2122
Practice Address - Fax:510-836-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC29049207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659472827Medicaid
CA1659472827Medicaid
A33824Medicare UPIN