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NPI Code Detail

MEDICARE: DR. JOSHUA PENN M.D.

MEDICARE:  DR. JOSHUA  PENN  M.D.
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
1174400000XSpecialistG76919CA

General Provider Information

NPI Number : 1679585731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA PENN M.D.
Provider Business Mailing Address
First Line : 1531 GLENVILLE DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90035-3107
Country : US
Telephone Number : 310-551-2750
Fax Number : 310-861-5620
Provider Business Practice Location Address
First Line : 250 N ROBERTSON BLVD
Second Line : SUITE 403
City : BEVERLY HILLS
State : CA
Zip : 90211-1793
Country : US
Telephone Number : 310-551-2750
Fax Number : 310-861-5620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 12/01/2009

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Directions to “ DR. JOSHUA PENN M.D.” Practice Location

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