Provider Demographics
NPI:1922669944
Name:DIZON, JOSHUA (RRT/RCP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:DIZON
Suffix:
Gender:M
Credentials:RRT/RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4077 W 3RD ST APT 225
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3100
Mailing Address - Country:US
Mailing Address - Phone:213-810-6157
Mailing Address - Fax:
Practice Address - Street 1:4077 W 3RD ST APT 225
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3100
Practice Address - Country:US
Practice Address - Phone:213-810-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406182279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care