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NPI Code Detail

MEDICARE: JUSTIN WRIGHT

MEDICARE:   JUSTIN  WRIGHT
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
1152WL0500XLow Vision Rehabilitation Optometrist36264CA

General Provider Information

NPI Number : 1386433191
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN WRIGHT
Provider Business Mailing Address
First Line : 16360 BRANCUSI LN
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-6109
Country : US
Telephone Number : 909-703-1211
Fax Number :
Provider Business Practice Location Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 800-541-6682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2025
Last Update Date : 06/26/2026

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Directions to “ JUSTIN WRIGHT ” Practice Location

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