Healthcare Provider Details

I. General information

NPI: 1619946563
Provider Name (Legal Business Name): JOE A PASTRANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

PO BOX 1747
MEDFORD OR
97501-0136
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3000
  • Fax:
Mailing address:
  • Phone: 541-773-2493
  • Fax: 541-779-3027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number11297
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD150962
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC192781
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD60074646
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: