Healthcare Provider Details

I. General information

NPI: 1649175613
Provider Name (Legal Business Name): JOSEPH MAAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 W ADAMS BLVD
LOS ANGELES CA
90018-1838
US

IV. Provider business mailing address

3615 KALSMAN DR UNIT 4
LOS ANGELES CA
90016-4435
US

V. Phone/Fax

Practice location:
  • Phone: 323-730-9400
  • Fax:
Mailing address:
  • Phone: 774-262-4209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: