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General NPI Number Information
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NPI Number | 1275596918
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Entity Type | Individual
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Provider Name | DR. JOEL STUART RESNICK
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Gender | Male
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 7281 DUMOSA AVE SUITE 1
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City | YUCCA VALLEY
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State | CA
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Zip | 92284-3769
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Country | US
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Telephone | 760-365-1882
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Fax |
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Provider Business Mailing Address
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Address Line | 14175 HALF MOON BAY DRIVE
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City | DELMAR
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State | CA
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Zip | 92014-2906
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Country | US
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Telephone | 858-205-3851
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Fax | 858-509-1960
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E-2177
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License Number State | CA
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