DR. DAE KEUN JOO (NPI# 1164757076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164757076 |
| Entity Type | Individual |
| Full Name | DR. DAE KEUN JOO |
| Other Name | DR. DAEKEUN JOO |
| Credential | M.D. |
| Practice Address |
10800 Magnolia Ave Riverside CA 92505-3043 |
| Mailing Address |
4000 Hoosier Lawn Way Yorba Linda CA 92886-7025 |
| Practice Telephone | 9513534738 |
| Mailing Telephone | 3105085377 |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2012-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | A93394 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
10800 MAGNOLIA AVE |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92505-3043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457352783 | Patrick Joseph S Alix | Internal Medicine | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2005-08-09 |
| 1306451885 | Tina Marsina Menedjian | Pharmacist | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-09-11 |
| 1346859246 | Christina Marie Stephenson | Pharmacist | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-07-27 |
| 1669095329 | Alvin Fong | Pharmacist | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-05-28 |
| 1114555810 | Michelle Eunbi Ko | Student in an Organized Health Care Education/Training Program | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-03-29 |
| 1821625062 | Christopher Mark Bradburne | Student in an Organized Health Care Education/Training Program | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-03-26 |
| 1740817659 | Lauren Khan | Student in an Organized Health Care Education/Training Program | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-03-23 |
| 1841826781 | Jessica Sherly Gurning | Student in an Organized Health Care Education/Training Program | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-03-22 |
| 1912533852 | Robert Yousif | Student in an Organized Health Care Education/Training Program | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-03-22 |
| 1770119323 | Erika Layne | Dietitian, Registered | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2020-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205458460 | Mark Anthony Vargas | Behavioral Analyst | 94193 Flat Rock Dr Ste 220, Riverside, CA 92505 | 2020-05-11 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1588222087 | A Homecare Services, Inc | In Home Supportive Care | 4193 Flat Rock Road, Building 200 Suite 206, Riverside, CA 92505 | 2019-05-31 |
| 1609302397 | Tap Pharmacy, Inc. | Pharmacy | 4270 Riverwalk Pkwy Ste 102, Riverside, CA 92505 | 2017-05-02 |
| 1467998658 | Onofre Gascon | Behavior Technician | 11711 Collett Ave, #1614, Riverside, CA 92505 | 2017-01-11 |
| 1780038505 | Nash David Martinez | Emergency Medicine | 10800 Magnolia Ave Dept of Emergency Medicine, Kaiser Permanente Hospital, Riverside, CA 92505 | 2016-04-18 |
| 1447639901 | Jose Joel Manalese Dds Inc | Dentist | 3950 Pierce St., Suite L., Riverside, CA 92505 | 2015-05-29 |
| 1821493230 | Jean Huynh | Physician Assistant | 11725 State Ave., Suite 100, Riverside, CA 92505 | 2014-10-28 |
| 1003160649 | Elaf Farahat | Dietitian, Registered | 10800 Magnolia Avenue., Riverside, CA 92505 | 2012-11-05 |
| 1730458217 | Tammy Lynn Gilmore | Non-emergency Medical Transport (VAN) | 10770 Hole Avenue, 106, Riverside, CA 92505 | 2011-12-29 |
| Find all providers in zip 92505 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613207 | Resurgent Head and Neck Surgeons, Inc. | Otolaryngology | 6848 Magnolia Ave Ste 220, Riverside, CA 92506-2858 | 2020-09-13 |
| 1194086389 | Mary D. Lekas | Otolaryngology | 129 Terrace Ave, Riverside, RI 02915-4726 | 2012-06-04 |
| 1396005740 | David William Hsu | Otolaryngology | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2012-05-19 |
| 1558518258 | Jack Liu | Otolaryngology | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2008-08-25 |
| 1710155452 | Brian Paul Boynton | Otolaryngology | 7117 Brockton Ave, Riverside, CA 92506-2615 | 2008-02-15 |
| 1013198456 | Inland Ear, Head & Neck Clinic | Otolaryngology | 3975 Jackson St, Ste. 202, Riverside, CA 92503-3901 | 2007-11-14 |
| 1649469800 | Piali Policarpio Dattaray | Otolaryngology | 6405 Day St, Riverside, CA 92507-0901 | 2007-10-23 |
| 1558565127 | Murtaza Zakirhusain Kharodawala | Otolaryngology | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2007-06-14 |
| 1720183403 | Riverside Medical Clinic Inc | Otolaryngology | 7160 Brockton Ave, Riverside, CA 92506 | 2006-09-14 |
| 1215910120 | Rhett Barry Nelson | Otolaryngology | 6405 Day St, Riverside, CA 92507-0901 | 2005-11-23 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.