Healthcare Provider Details

I. General information

NPI: 1255434502
Provider Name (Legal Business Name): PABLO A JOO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3390 UNIVERSITY AVE STE 100
RIVERSIDE CA
92501-3315
US

IV. Provider business mailing address

3390 UNIVERSITY AVE STE 100
RIVERSIDE CA
92501-3315
US

V. Phone/Fax

Practice location:
  • Phone: 844-827-8000
  • Fax:
Mailing address:
  • Phone: 844-827-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number205647
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: