Provider Demographics
NPI:1487199428
Name:FRANCESCHI, JOE EDWARD OSCAR
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:EDWARD OSCAR
Last Name:FRANCESCHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 FRANKLIN ST APT E
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1634
Mailing Address - Country:US
Mailing Address - Phone:619-204-3172
Mailing Address - Fax:
Practice Address - Street 1:1244 FRANKLIN ST APT E
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1634
Practice Address - Country:US
Practice Address - Phone:619-204-3172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54066363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant