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NPI Code Detail

MEDICARE: JOSHUA ENGLE MD

MEDICARE: JOSHUA ENGLE MD
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
1208D00000XGeneral Practice Physician320290NY
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1366070112
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA ENGLE MD
Provider Business Mailing Address
First Line : 702 BROADWAY UNIT 4109
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-5371
Country : US
Telephone Number : 925-639-7503
Fax Number :
Provider Business Practice Location Address
First Line : 240 W 37TH ST FL 5
Second Line :
City : NEW YORK
State : NY
Zip : 10018-5787
Country : US
Telephone Number : 917-268-8951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2020
Last Update Date : 07/31/2024

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