Provider Demographics
NPI:1356480347
Name:MIZZELL, JOSEPH III (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MIZZELL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9850 GENESEE AVE
Mailing Address - Street 2:SUITE 780
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1224
Mailing Address - Country:US
Mailing Address - Phone:858-625-7200
Mailing Address - Fax:858-625-8363
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:SUITE 780
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1224
Practice Address - Country:US
Practice Address - Phone:858-625-7200
Practice Address - Fax:858-625-8363
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA111893207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease