Healthcare Provider Details

I. General information

NPI: 1497239727
Provider Name (Legal Business Name): JOSEPH BENEDICT VERZOSA MERCADO RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2018
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

21880 PROPELLO DR
SANTA CLARITA CA
91350-8543
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-7920
  • Fax:
Mailing address:
  • Phone: 818-687-6768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number21732
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: