Provider Demographics
NPI:1891876520
Name:JOSEPH, ROBERT II (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:JOSEPH
Suffix:II
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N ROBERTSON BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2145
Mailing Address - Country:US
Mailing Address - Phone:310-652-2562
Mailing Address - Fax:310-967-3698
Practice Address - Street 1:150 N ROBERTSON BLVD
Practice Address - Street 2:STE 300
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-652-2562
Practice Address - Fax:310-967-3698
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4013213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU62769Medicare UPIN