Individual provider Active NPI

Pablo A Joo, M.D.

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1255434502
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
205647 Issued in NY
Practice address
3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone
(844) 827-8000
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 205647 NY Primary

Addresses

Primary practice location

3390 University Ave Ste 100
Riverside, CA 92501-3315

Mailing address

3390 University Ave Ste 100
Riverside, CA 92501-3315
Phone (844) 827-8000

Other identifiers 1

IdentifierTypeStateIssuer
01811398MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
205647NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Westchester SQ Med Ctr Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1255434502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 UNIVERSITY AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013315",
            "telephone_number": "844-827-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOO",
        "first_name": "PABLO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "205647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01811398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.