Provider Demographics
NPI:1801898044
Name:ACHARYA, JOYDEV (MD)
Entity type:Individual
Prefix:DR
First Name:JOYDEV
Middle Name:
Last Name:ACHARYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 FOREST GLENN DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-1339
Mailing Address - Country:US
Mailing Address - Phone:209-521-9661
Mailing Address - Fax:209-521-2640
Practice Address - Street 1:3621 FOREST GLENN DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-1339
Practice Address - Country:US
Practice Address - Phone:209-521-9661
Practice Address - Fax:209-521-9307
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96042174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902828841Medicaid
CA1902828841Medicaid