Provider Demographics
NPI:1609071885
Name:JOEL R. SHEINER, M.D., INC.
Entity Type:Organization
Organization Name:JOEL R. SHEINER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-631-5301
Mailing Address - Street 1:320 SUPERIOR AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-2716
Mailing Address - Country:US
Mailing Address - Phone:949-631-5301
Mailing Address - Fax:949-642-2170
Practice Address - Street 1:320 SUPERIOR AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2716
Practice Address - Country:US
Practice Address - Phone:949-631-5301
Practice Address - Fax:949-642-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA040176208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A401760Medicaid
CA00A401760Medicaid
CAW18471Medicare ID - Type Unspecified