Provider Demographics
NPI:1457440471
Name:DOUMIT, JOSEPH RAYMOND (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RAYMOND
Last Name:DOUMIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6261 KATELLA AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5249
Mailing Address - Country:US
Mailing Address - Phone:714-820-1657
Mailing Address - Fax:855-663-2244
Practice Address - Street 1:6261 KATELLA AVE STE 150
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5249
Practice Address - Country:US
Practice Address - Phone:714-820-1657
Practice Address - Fax:855-663-2244
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD602328892084P0800X
MDD00639312084P0800X
AZ592772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
100104919OtherAPS
119591300OtherMD PHYSICIANS CARE
357675OtherMAMSI
E1540042OtherCAREFIRST BLUE CHOICE
054635OtherJHHC
MD119591300Medicaid
309308OtherANTHEM SALISBURY
521860379OtherINFORMED
600018703OtherMAGELLAN
309302OtherANTHEM PRINCESS ANNE
WA0284968OtherLABOR AND INDUSTRY
521860379OtherUNITED BEHAVIORAL HEALTH
77709886OtherAETNA
WA1457440471Medicaid
77709886OtherAETNA
WA8906425Medicare PIN
119591300OtherMD PHYSICIANS CARE
357675OtherMAMSI