Healthcare Provider Details

I. General information

NPI: 1225322357
Provider Name (Legal Business Name): JOSHUA ANDREW SIEMBIEDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 09/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1000 W CARSON ST BOX 21
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3503
  • Fax: 310-212-6101
Mailing address:
  • Phone: 310-222-3503
  • Fax: 310-212-6101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA124630
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: