Provider Demographics
NPI:1194711176
Name:JUSTICE, JAMES C (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:JUSTICE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:DEPT LA23517
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-3517
Mailing Address - Country:US
Mailing Address - Phone:866-457-6411
Mailing Address - Fax:706-650-1034
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-739-3100
Practice Address - Fax:805-739-3060
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2021-12-03
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Provider Licenses
StateLicense IDTaxonomies
CAA71616207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A716160Medicaid
CAWA71616AMedicare PIN
CAH67503Medicare UPIN