Search › California › 101YM0800X
Justin Broussard
NPI 1326310632 · on the registry since 2012 · sole proprietor
Practice
- Address
- 3765 S. Higuera
Suite 100
San Louis Obispo, CA 93401 - Phone
- (805) 781-3535
- Fax
- (805) 503-6499
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-01-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California