Provider Demographics
NPI:1114224797
Name:AGACID, JOEL A JR (RCP)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:A
Last Name:AGACID
Suffix:JR
Gender:M
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:328 PARKMAN AVE
Mailing Address - Street 2:APT. # 2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-4506
Mailing Address - Country:US
Mailing Address - Phone:213-926-4407
Mailing Address - Fax:
Practice Address - Street 1:1 CIVIC PLAZA DR
Practice Address - Street 2:SUITE 625
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2243
Practice Address - Country:US
Practice Address - Phone:310-549-4500
Practice Address - Fax:310-549-4700
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA21271227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified