Provider Demographics
NPI:1972604148
Name:ROBERT H. JOSEPH, M.D., INC.
Entity Type:Organization
Organization Name:ROBERT H. JOSEPH, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-496-0592
Mailing Address - Street 1:1240 S WESTLAKE BLVD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1929
Mailing Address - Country:US
Mailing Address - Phone:805-496-0592
Mailing Address - Fax:805-494-1017
Practice Address - Street 1:1240 S WESTLAKE BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-1929
Practice Address - Country:US
Practice Address - Phone:805-496-0592
Practice Address - Fax:805-494-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG21058174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty