Provider Demographics
NPI:1003347618
Name:GOTTLIEB, JOSHUA (DO)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:GOTTLIEB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2701 W ALAMEDA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4406
Mailing Address - Country:US
Mailing Address - Phone:818-853-9659
Mailing Address - Fax:818-843-0380
Practice Address - Street 1:2701 W ALAMEDA AVE STE 200
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4406
Practice Address - Country:US
Practice Address - Phone:818-853-9659
Practice Address - Fax:818-843-0380
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A19692208800000X, 208800000X
CA19692208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology