Provider Demographics
NPI:1912797101
Name:JOSEPH YACOUB DPM INC
Entity type:Organization
Organization Name:JOSEPH YACOUB DPM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:YACOUB
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:909-419-6781
Mailing Address - Street 1:15747 PISTACHIO ST
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3816
Mailing Address - Country:US
Mailing Address - Phone:909-419-6781
Mailing Address - Fax:
Practice Address - Street 1:5750 DOWNEY AVE STE 203
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1471
Practice Address - Country:US
Practice Address - Phone:562-200-0334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty