Provider Demographics
NPI:1194995498
Name:HASKELL, JOSEPH DONALD
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DONALD
Last Name:HASKELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 BOBWHITE CT
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6158
Mailing Address - Country:US
Mailing Address - Phone:805-258-4802
Mailing Address - Fax:
Practice Address - Street 1:1223 BOBWHITE CT
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6158
Practice Address - Country:US
Practice Address - Phone:805-258-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHF87471247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist