Provider Demographics
NPI:1952337719
Name:TERRAZZINO, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:TERRAZZINO
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:PO BOX 55115
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91385-0115
Mailing Address - Country:US
Mailing Address - Phone:661-298-7423
Mailing Address - Fax:661-298-7423
Practice Address - Street 1:23823 VALENCIA BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2103
Practice Address - Country:US
Practice Address - Phone:661-254-0172
Practice Address - Fax:661-254-0017
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75356208100000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG75356OMedicaid
CAE76675Medicare UPIN
CAOOG75356OMedicaid