Dominick, Justin E
Dominick, Justin E is an individual health care provider with primary practice located at 18370 Burbank Blvd 107, Tarzana CA 91356-2813. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Dominick, Justin E can be contacted via phone (818) 996-3880.Contact Information
Primary practice address
18370 Burbank Blvd 107
Tarzana CA 91356-2813
Phone: (818) 996-3880
Fax: (818) 996-1679
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | A75156 | California |
Profile Details
| NPI number | 1669497038 |
|---|---|
| LBN Legal business name | Dominick, Justin E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Apr 20th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669497038 | NPPES |
| California | MEDICAID | 00A751560 |
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