Healthcare Provider Details

I. General information

NPI: 1407856354
Provider Name (Legal Business Name): JOEL J. LIPKIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5907 LANKERSHIM BLVD
N HOLLYWOOD CA
91601-1006
US

IV. Provider business mailing address

32565-B GOLDEN LANTERN STREET #142
DANA POINT CA
92629-3261
US

V. Phone/Fax

Practice location:
  • Phone: 818-980-3073
  • Fax: 877-340-3470
Mailing address:
  • Phone: 714-878-2002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE2802
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4839
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: