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General NPI Number Information
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NPI Number | 1508960527
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Entity Type | Individual
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Provider Name | JOEL A LARDIZABAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 835 AEROVISTA PL
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-8740
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Country | US
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Telephone | 805-457-9568
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Fax | 805-457-9569
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Provider Business Mailing Address
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Address Line | PO BOX 13578
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City | BAKERSFIELD
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State | CA
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Zip | 93389-3578
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Country | US
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Telephone | 661-493-8938
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Fax | 661-495-2123
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A92530
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License Number State | CA
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