Provider Demographics
NPI:1356351787
Name:KILEY, JAMES ANTHONY JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANTHONY
Last Name:KILEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:271 TURN PIKE DR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8098
Mailing Address - Country:US
Mailing Address - Phone:916-985-9300
Mailing Address - Fax:916-355-1458
Practice Address - Street 1:271 TURN PIKE DR
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8098
Practice Address - Country:US
Practice Address - Phone:916-985-9300
Practice Address - Fax:916-355-1458
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2011-08-18
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Provider Licenses
StateLicense IDTaxonomies
CAG050424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G504240Medicare ID - Type Unspecified
CAA51675Medicare UPIN