Basic Information
| Provider Information | |||||||||
| NPI: | 1902240344 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RESTREPO | ||||||||
| FirstName: | JULIAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 70180 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925130180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513543216 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 ICON | ||||||||
| Address2: | |||||||||
| City: | FOOTHILL RANCH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926103000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9499007136 | ||||||||
| FaxNumber: | 9499007302 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2013 | ||||||||
| LastUpdateDate: | 10/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A136382 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 208D00000X | A136382 | CA | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.