Provider Demographics
NPI:1568079317
Name:WARR, JOSHUA DOUGLAS (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DOUGLAS
Last Name:WARR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25014 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2900
Mailing Address - Country:US
Mailing Address - Phone:801-310-2625
Mailing Address - Fax:
Practice Address - Street 1:25014 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2900
Practice Address - Country:US
Practice Address - Phone:801-310-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant