Provider Demographics
NPI:1588660955
Name:RINGOLD, JOEL N/A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:N/A
Last Name:RINGOLD
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 1:3500 W. LOMITA BLVD
Mailing Address - Street 2:STE 305
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5021
Mailing Address - Country:US
Mailing Address - Phone:310-539-6040
Mailing Address - Fax:310-539-7307
Practice Address - Street 1:3500 W. LOMITA BLVD
Practice Address - Street 2:STE 305
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5021
Practice Address - Country:US
Practice Address - Phone:310-539-6040
Practice Address - Fax:310-539-7307
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2007-11-16
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
CAG10261207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G102610Medicaid
CA00G102610Medicaid
CAA37917Medicare UPIN