Healthcare Provider Details
I. General information
NPI: 1528024544
Provider Name (Legal Business Name): JOSEPH MICHAEL ARCIDI JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2700 DOLBEER ST
EUREKA CA
95501-4736
US
IV. Provider business mailing address
608 MARTIN WAY
EUREKA CA
95503-6457
US
V. Phone/Fax
- Phone: 707-445-8121
- Fax: 707-407-6113
- Phone: 810-513-9232
- Fax: 508-519-0465
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | C50460 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 4301097553 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: