Healthcare Provider Details

I. General information

NPI: 1407046329
Provider Name (Legal Business Name): JOSHUA ANGELO TOURNAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C340 MEDICAL SCIENCES I UC IRVINE DERMATOLOGY
IRVINE CA
92697-0001
US

IV. Provider business mailing address

C340 MEDICAL SCIENCES I UC IRVINE DERMATOLOGY
IRVINE CA
92697-0001
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-5515
  • Fax: 949-824-7454
Mailing address:
  • Phone: 949-824-5515
  • Fax: 949-824-7454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA88473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: