Blackmon, Justin

Blackmon, Justin is an individual health care provider with primary practice located at 9888 Genesee Ave , La Jolla CA 92037-1205. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Blackmon, Justin can be contacted via phone (858) 626-4123.

Contact Information

Primary practice address
9888 Genesee Ave La Jolla CA 92037-1205
Phone: (858) 626-4123
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA031058 District of Columbia
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085.005596 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 53958 California

Profile Details

NPI number 1699182832
LBN Legal business name Blackmon, Justin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2014
Last updated Oct 31st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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