Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 18823 | CA |
NPI | 1700885126 |
---|---|
Provider Name | Dr. Joel Horowitz |
First Address | Pinole, CA 94564-2343 |
Second Address | Pinole, CA 94564-2343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T93496 | (02) | CA |