Provider Demographics
NPI:1841216041
Name:BEIRNE, JOSHUA P (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:P
Last Name:BEIRNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 DOYLE PARK DR
Mailing Address - Street 2:SUITE G04
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4558
Mailing Address - Country:US
Mailing Address - Phone:707-303-8360
Mailing Address - Fax:707-303-8361
Practice Address - Street 1:500 DOYLE PARK DR
Practice Address - Street 2:SUITE G04
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4558
Practice Address - Country:US
Practice Address - Phone:707-303-8360
Practice Address - Fax:707-303-8361
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91482207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFD712YMedicare PIN