Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A123699 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | A123699 | CA |
NPI | 1184919474 |
---|---|
Provider Name | Dr. Joseph Earl Treister |
First Address | Stockton, CA 95267-0096 |
Second Address | Madera, CA 93636-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2011 |
Last Update Date | 21/06/2017 |