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NPI Code Detail

MEDICARE: JOSHUA PUIG PA-C

MEDICARE: JOSHUA PUIG PA-C
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
1363A00000XPhysician Assistant59620CA
2363A00000XPhysician Assistant10002663AIN
3363A00000XPhysician AssistantPA11148TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA11148OTHERTXTEXAS STATE MEDICAL BOARD

General Provider Information

NPI Number : 1679019863
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA PUIG PA-C
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 757 WESTWOOD PLZ
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-8358
Country : US
Telephone Number : 310-206-8232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2017
Last Update Date : 06/12/2026

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Directions to “ JOSHUA PUIG PA-C” Practice Location

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