Provider Demographics
NPI:1912082017
Name:LAVI, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:LAVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:27420 TOURNEY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5601
Mailing Address - Country:US
Mailing Address - Phone:661-254-9950
Mailing Address - Fax:661-254-9956
Practice Address - Street 1:27420 TOURNEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5601
Practice Address - Country:US
Practice Address - Phone:661-254-9950
Practice Address - Fax:661-254-9956
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2014-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA72094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19737Medicare ID - Type Unspecified
CAH57333Medicare UPIN