Healthcare Provider Details

I. General information

NPI: 1730631730
Provider Name (Legal Business Name): ARNEL M JOAQUIN, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S CENTRAL AVE STE 320
GLENDALE CA
91204-2561
US

IV. Provider business mailing address

1500 S CENTRAL AVE STE 320
GLENDALE CA
91204-2561
US

V. Phone/Fax

Practice location:
  • Phone: 213-880-3305
  • Fax: 888-395-2566
Mailing address:
  • Phone: 213-880-3305
  • Fax: 888-395-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA51799
License Number StateCA

VIII. Authorized Official

Name: ARNEL MONTELOYOLA JOAQUIN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 213-880-3305