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General NPI Number Information
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NPI Number | 1972192888
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Entity Type | Organization
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Legal Business Name | JUSTLAND MEDICAL GROUP, INC
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 18384 BROOKHURST ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6704
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Country | US
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Telephone | 714-861-9209
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Fax |
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Provider Business Mailing Address
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Address Line | 18384 BROOKHURST ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6704
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Country | US
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Telephone | 714-861-9209
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LYNDA TRAN NGO
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Credential |
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Telephone | 714-378-5223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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