Provider Demographics
NPI:1225591506
Name:SECOR-TADDIA, JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SECOR-TADDIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 S EL CAMINO REAL STE 117-122
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6203
Mailing Address - Country:US
Mailing Address - Phone:760-730-8060
Mailing Address - Fax:760-730-8061
Practice Address - Street 1:2170 S EL CAMINO REAL STE 117-122
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6203
Practice Address - Country:US
Practice Address - Phone:760-730-8060
Practice Address - Fax:760-730-8061
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A23134204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM