Justice, Glen Robert

Justice, Glen Robert is an individual health care provider with primary practice located at 9940 Talbert Ave Ste 100, Fountain Valley CA 92708-5153. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Justice, Glen Robert can be contacted via phone (714) 845-0200.

Contact Information

Primary practice address
9940 Talbert Ave Ste 100 Fountain Valley CA 92708-5153
Phone: (714) 845-0200
Fax: (714) 435-1420
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G23862 California
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X G23862 California

Profile Details

NPI number 1295731826
LBN Legal business name Justice, Glen Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Oct 3rd, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1295731826 NPPES
California Other 953431486 0073 CIGNA
California MEDICAID 00G238620 CIGNA
California Other ZZZ21205Z CIGNA

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