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NPI Code Detail

MEDICARE: MR. JOSEPH JOHN MIHAL III BCBA

MEDICARE: MR. JOSEPH JOHN MIHAL III BCBA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1801399464
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH JOHN MIHAL III BCBA
Provider Business Mailing Address
First Line : 5550 HOLLYWOOD BLVD APT 723
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-9618
Country : US
Telephone Number : 858-776-9010
Fax Number :
Provider Business Practice Location Address
First Line : 1063 MCGAW AVE
Second Line :
City : IRVINE
State : CA
Zip : 92614-5505
Country : US
Telephone Number : 714-834-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2018
Last Update Date : 09/18/2024

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