Healthcare Provider Details

I. General information

NPI: 1588019657
Provider Name (Legal Business Name): JOSHUA WILLIAM HOTZ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5810 EL CAMINO REAL SUITE A
CARLSBAD CA
92008-8819
US

IV. Provider business mailing address

5810 EL CAMINO REAL SUITE A
CARLSBAD CA
92008-8819
US

V. Phone/Fax

Practice location:
  • Phone: 760-929-8269
  • Fax:
Mailing address:
  • Phone: 760-929-8269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95084116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: