Healthcare Provider Details
I. General information
NPI: 1841012374
Provider Name (Legal Business Name): JUSTE MEDICAL A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9676 LAS TUNAS DR STE B
TEMPLE CITY CA
91780-2160
US
IV. Provider business mailing address
9676 LAS TUNAS DR STE B
TEMPLE CITY CA
91780-2160
US
V. Phone/Fax
- Phone: 626-287-6513
- Fax: 626-287-6497
- Phone: 626-287-6513
- Fax: 626-287-6497
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANCK
JUSTE
Title or Position: ONWER
Credential: MD
Phone: 760-550-5980