Provider Demographics
NPI:1821152356
Name:JOSEPH, GEORGE A (MD)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:A
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6020 SEABLUFF DR
Mailing Address - Street 2:UNIT 1
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2252
Mailing Address - Country:US
Mailing Address - Phone:310-862-0400
Mailing Address - Fax:310-862-0402
Practice Address - Street 1:6020 SEABLUFF DR
Practice Address - Street 2:SUITE 1
Practice Address - City:PLAYA VISTA
Practice Address - State:CA
Practice Address - Zip Code:90094-2252
Practice Address - Country:US
Practice Address - Phone:310-862-0400
Practice Address - Fax:310-862-0402
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2014-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG27387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine