Provider Demographics
NPI:1215960851
Name:JOSHUA N. BABAD, M. D. A MEDICAL CORPORATION
Entity type:Organization
Organization Name:JOSHUA N. BABAD, M. D. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BABAD
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:831-426-2550
Mailing Address - Street 1:515 SOQUEL AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2309
Mailing Address - Country:US
Mailing Address - Phone:831-426-2550
Mailing Address - Fax:831-426-5143
Practice Address - Street 1:515 SOQUEL AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2309
Practice Address - Country:US
Practice Address - Phone:831-426-2550
Practice Address - Fax:831-426-5143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22841261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41742Medicare UPIN