Provider Demographics
NPI:1275997074
Name:DR JOSHUA SAMEER PAL, MD CORPORATION
Entity Type:Organization
Organization Name:DR JOSHUA SAMEER PAL, MD CORPORATION
Other - Org Name:PROACTIVE HEALTH SOLUTIONS,INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:SAMEER
Authorized Official - Last Name:PAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-777-3520
Mailing Address - Street 1:3142 E. PLAZA BLVD., SUITE T
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950
Mailing Address - Country:US
Mailing Address - Phone:619-327-6598
Mailing Address - Fax:619-475-6507
Practice Address - Street 1:3142 E. PLAZA BLVD., SUITE T
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950
Practice Address - Country:US
Practice Address - Phone:619-327-6598
Practice Address - Fax:619-475-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104765208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty