Healthcare Provider Details

I. General information

NPI: 1255968590
Provider Name (Legal Business Name): JOSHUA A ARVIZU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 08/03/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20601 W PAOLI LN
WEIMAR CA
95736
US

IV. Provider business mailing address

PO BOX 518
WEIMAR CA
95736-0518
US

V. Phone/Fax

Practice location:
  • Phone: 530-637-4025
  • Fax:
Mailing address:
  • Phone: 530-637-4025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA180487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: