Provider Demographics
NPI:1184857724
Name:PALAU, JOSEPH J
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:PALAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:J
Other - Last Name:PALAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8172 EVELYNE CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5520
Mailing Address - Country:US
Mailing Address - Phone:858-344-1368
Mailing Address - Fax:
Practice Address - Street 1:1717 W ORANGEWOOD AVE
Practice Address - Street 2:#1
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2040
Practice Address - Country:US
Practice Address - Phone:714-712-8340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner