Healthcare Provider Details

I. General information

NPI: 1932944188
Provider Name (Legal Business Name): JOSHUA PADILLA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST # C
LOMA LINDA CA
92350-1716
US

IV. Provider business mailing address

10913 RAGSDALE RD
LOMA LINDA CA
92354-6546
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number20A24693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: