Provider Demographics
NPI:1710250345
Name:HALL, JOYCE NOVERAS (MD)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:NOVERAS
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:LORENZO
Other - Last Name:NOVERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2538 QUIDDE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-4025
Mailing Address - Country:US
Mailing Address - Phone:757-869-9889
Mailing Address - Fax:
Practice Address - Street 1:COMNAVSURFPAC 2841 RENDOVA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92155-2197
Practice Address - Country:US
Practice Address - Phone:619-881-9169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101254466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine