Healthcare Provider Details

I. General information

NPI: 1083935951
Provider Name (Legal Business Name): JOSEPH AARON SIEGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 01/17/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MERCY CIRCLE
OCEANSIDE CA
92055
US

IV. Provider business mailing address

200 MERCY CIRCLE
OCEANSIDE CA
92055
US

V. Phone/Fax

Practice location:
  • Phone: 424-421-4234
  • Fax:
Mailing address:
  • Phone: 424-421-4234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number65890
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number65890
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number65890
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: