MEDICARE: TINSU JOSEPH

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	225100000X	Physical Therapist
2	225100000X	Physical Therapist	301470	CA

General Provider Information

NPI Number	:	1992304158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINSU JOSEPH

Provider Business Mailing Address
First Line	:	771 KENMARE DR
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-8704
Country	:	US
Telephone Number	:	847-331-7954
Fax Number	:

Provider Business Practice Location Address
First Line	:	433 SOSCOL AVE
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94559-4036
Country	:	US
Telephone Number	:	916-705-8273
Fax Number	:

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

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	01/28/2022

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Directions to “ TINSU JOSEPH ” Practice Location

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