Individual
JOSEPH CHARLES POEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 S ELISEO DR, #100, GREENBRAE, CA 94904-2011
(209) 342-2300
(209) 324-4240
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G66706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G667060
BLUE SHIELD
CA
05
—
00G667060
—
CA
Enumeration date
11/16/2005
Last updated
12/08/2008
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