Healthcare Provider Details

I. General information

NPI: 1659203602
Provider Name (Legal Business Name): JOHN PAUL ALEXANDER YOSEPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 CASE RD BLDG C
PERRIS CA
92570-5552
US

IV. Provider business mailing address

11681 NELSON ST
LOMA LINDA CA
92354-3902
US

V. Phone/Fax

Practice location:
  • Phone: 951-564-4091
  • Fax:
Mailing address:
  • Phone: 224-717-0933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: