Healthcare Provider Details

I. General information

NPI: 1790244788
Provider Name (Legal Business Name): JOUBEEN S FOLADPOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W PACIFIC COAST HWY # D
WILMINGTON CA
90744-2552
US

IV. Provider business mailing address

1510 LEXINGTON AVE APT 10T
NEW YORK NY
10029-7163
US

V. Phone/Fax

Practice location:
  • Phone: 213-947-1759
  • Fax:
Mailing address:
  • Phone: 310-746-8210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number333943
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA199999
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA199999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: