Provider Demographics
NPI:1902801939
Name:BABAD, JOSHUA N (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:N
Last Name:BABAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22841207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41742Medicare UPIN