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General NPI Number Information
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NPI Number | 1497341747
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Entity Type | Individual
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Provider Name | JUBIN PUTHENPARAMPU JOSEPH MD PHD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2020
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 1510 SAN PABLO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-5320
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Country | US
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Telephone | 323-865-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 8665 BURTON WAY APT 301
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City | LOS ANGELES
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State | CA
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Zip | 90048-3993
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Country | US
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Telephone | 323-504-2608
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | PTL2639
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | A180893
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License Number State | CA
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