Provider Demographics
NPI:1386806156
Name:HUNT, JUSTIN (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:HUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 PENTZ RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-3672
Mailing Address - Country:US
Mailing Address - Phone:254-654-3939
Mailing Address - Fax:
Practice Address - Street 1:6480 PENTZ RD
Practice Address - Street 2:SUITE A
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-3672
Practice Address - Country:US
Practice Address - Phone:530-877-4983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131362208600000X
TXN4483208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery