MEDICARE: DR. JUSTIN JAMES NORK D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	20A16623	CA
2	208800000X	Urology Physician	DO-P-2025-002	GU
3	208600000X	Surgery Physician	0116018955	VA

General Provider Information

NPI Number	:	1093897860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN JAMES NORK D.O.

Provider Business Mailing Address
First Line	:	NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-0001
Country	:	US
Telephone Number	:	619-532-7200
Fax Number	:	619-532-7234

Provider Business Practice Location Address
First Line	:	NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-0001
Country	:	US
Telephone Number	:	619-532-7200
Fax Number	:	619-532-7234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	01/28/2026

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