Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 34126 | CA |
Y | 213EG0000X | General Practice | 34126 | CA |
NPI | 1003868068 |
---|---|
Provider Name | Prafulla Joshi |
First Address | Los Angeles, CA 90008-1816 |
Second Address | Los Angeles, CA 90008-1816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 14/07/2015 |