Healthcare Provider Details

I. General information

NPI: 1326305657
Provider Name (Legal Business Name): JOSHUA W MAJOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 10/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR NAVAL MEDICAL CENTER
SAN DIEGO CA
92134-5000
US

IV. Provider business mailing address

1606 HUMBOLDT ST
BELLINGHAM WA
98225-4814
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-8429
  • Fax:
Mailing address:
  • Phone: 360-920-9259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberMD17194
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: