Basic Information
| Provider Information | |||||||||
| NPI: | 1598949422 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOSEPH | ||||||||
| FirstName: | VICTOR | ||||||||
| MiddleName: | RICARDO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7080 | ||||||||
| Address2: | |||||||||
| City: | NORCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928608069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517372683 | ||||||||
| FaxNumber: | 9512732328 | ||||||||
| Practice Location | |||||||||
| Address1: | 5TH & WESTERN | ||||||||
| Address2: | CALIFORNIA REHABILITATION CENTER | ||||||||
| City: | NORCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928608069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517372683 | ||||||||
| FaxNumber: | 9512732328 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2007 | ||||||||
| LastUpdateDate: | 12/27/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 36507 | CA | Y | Dental Providers | Dentist |
No ID Information.