Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 239762 | NY |
Y | 208000000X | Pediatrician | C174470 | CA |
N | 2080P0202X | Pediatric Cardiologist | C174470 | CA |
N | 2080P0202X | Pediatric Cardiologist | MD426797 | PA |
NPI | 1275831562 |
---|---|
Provider Name | Joshua Jacob Blinder |
First Address | Palo Alto, CA 94304-1601 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2011 |
Last Update Date | 07/09/2021 |