Basic Information
| Provider Information | |||||||||
| NPI: | 1316088693 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RESENDIZ | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 430 NW LOST SPRINGS TER STE 405 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972296558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8166656582 | ||||||||
| FaxNumber: | 5034308189 | ||||||||
| Practice Location | |||||||||
| Address1: | 430 NW LOST SPRINGS TER STE 405 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972296558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036565273 | ||||||||
| FaxNumber: | 5036504828 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2007 | ||||||||
| LastUpdateDate: | 05/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DO26421 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.