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NPI Code Detail

MEDICARE: DR. JOEL JESUS PAULINO M.D.

MEDICARE: DR. JOEL JESUS PAULINO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianAZ28843AZ
2207R00000XInternal Medicine PhysicianMD61251686WA

General Provider Information

NPI Number : 1144221730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOEL JESUS PAULINO M.D.
Provider Business Mailing Address
First Line : 2771 SILVER CREEK RD
Second Line : SUITE 101
City : BULLHEAD CITY
State : AZ
Zip : 86442-7959
Country : US
Telephone Number : 927-704-0222
Fax Number : 928-704-2666
Provider Business Practice Location Address
First Line : 9505 S STEELE ST
Second Line :
City : TACOMA
State : WA
Zip : 98444-1858
Country : US
Telephone Number : 253-597-6800
Fax Number : 253-597-6888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 09/29/2022

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