Provider Demographics
NPI:1467556951
Name:FINE, JOEL ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ALAN
Last Name:FINE
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 1:555 MASON ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4612
Mailing Address - Country:US
Mailing Address - Phone:707-447-3880
Mailing Address - Fax:
Practice Address - Street 1:555 MASON ST
Practice Address - Street 2:SUITE 260
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4612
Practice Address - Country:US
Practice Address - Phone:707-447-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG676282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry