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General NPI Number Information
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NPI Number | 1225591506
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Entity Type | Individual
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Provider Name | JOSEPH SECOR-TADDIA DO
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Gender | Male
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2170 S EL CAMINO REAL STE 117-122
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City | OCEANSIDE
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State | CA
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Zip | 92054-6203
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Country | US
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Telephone | 760-730-8060
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Fax | 760-730-8061
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Provider Business Mailing Address
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Address Line | 2170 S EL CAMINO REAL STE 117-122
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City | OCEANSIDE
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State | CA
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Zip | 92054-6203
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Country | US
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Telephone | 760-730-8060
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Fax | 760-730-8061
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 20A23134
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License Number State | CA
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