Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | G39220 | CA |
NPI | 1013037779 |
---|---|
Provider Name | Dr. Joel Douglas Epstein |
First Address | Lakewood, CA 90712-1502 |
Second Address | Lakewood, CA 90712-1502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G392200 | (05) | CA |
A92055 | (02) | CA |