MEDICARE: JOE ARBOUR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	NA	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER	CA	PAIN PATCH MANUFACTURER

General Provider Information

NPI Number	:	1649918889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE ARBOUR

Provider Business Mailing Address
First Line	:	5702 BOLSA AVE STE 200
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-1128
Country	:	US
Telephone Number	:	722-622-1145
Fax Number	:	714-622-1146

Provider Business Practice Location Address
First Line	:	5702 BOLSA AVE STE 200
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-1128
Country	:	US
Telephone Number	:	722-622-1145
Fax Number	:	714-622-1146

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	05/26/2022

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Directions to “ JOE ARBOUR ” Practice Location

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