Provider Demographics
NPI:1285893677
Name:SHOW, JOYCE (MD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:
Last Name:SHOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOYCE
Other - Middle Name:SHOW
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1808 VERDUGO BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1412
Mailing Address - Country:US
Mailing Address - Phone:818-790-7611
Mailing Address - Fax:
Practice Address - Street 1:1808 VERDUGO BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1412
Practice Address - Country:US
Practice Address - Phone:818-790-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG062286207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB74896Medicare UPIN