Provider Demographics
NPI:1972589869
Name:ESHAGHIAN, JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:ESHAGHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1211 N VERMONT AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1748
Mailing Address - Country:US
Mailing Address - Phone:323-663-3333
Mailing Address - Fax:323-661-1197
Practice Address - Street 1:1211 N VERMONT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1748
Practice Address - Country:US
Practice Address - Phone:323-663-3333
Practice Address - Fax:323-661-1197
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG38640207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G386400Medicaid
CAE91285Medicare UPIN
CA00G386400Medicaid