Provider Demographics
NPI:1912796830
Name:NEW, JOEL Z
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:Z
Last Name:NEW
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 OBERLIN DR STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3744
Mailing Address - Country:US
Mailing Address - Phone:858-247-3162
Mailing Address - Fax:
Practice Address - Street 1:5820 OBERLIN DR STE 203
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3744
Practice Address - Country:US
Practice Address - Phone:858-247-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner