=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023204872
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RONALD JOSEPH MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2007
-----------------------------------------------------
Last Update Date | 09/14/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14601 S BASCOM AVE SUITE 200
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95032-2043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-356-0464
-----------------------------------------------------
Fax | 408-356-9620
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14601 S BASCOM AVE SUITE 200
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95032-2043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-356-0464
-----------------------------------------------------
Fax | 408-356-9620
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RONALD JOSEPH
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 408-356-0464
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | G035384
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------