DR. GLEN ROBERT JUSTICE M.D. NPI 1295731826

NPI Information

NPI: 1295731826
Provider Name: DR. GLEN ROBERT JUSTICE, M.D.
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Address:
9940 TALBERT AVE
STE 100
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (714) 845-0200
Get Directions

DR. Glen Robert Justice, M.D. is a hematology and oncology internal medicine in Fountain Valley, CA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. DR. Glen Robert Justice, M.D. NPI is 1295731826. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9940 TALBERT AVE
STE 100
FOUNTAIN VALLEY, CA
ZIP 92708-153
Phone: (714) 845-0200
Fax: (714) 435-1420

The enumeration date for this NPI number is 6/28/2005 and was last updated on 10/3/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		G23862	CALIFORNIA	No
2	207RH0003X	Internal Medicine	Hematology & Oncology	G23862	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ZZZ21205Z	OTHER	CALIFORNIA	BLUE SHIELD OF CALIFORNIA
2	953431486 0073	OTHER	CALIFORNIA	CIGNA
3	A42091	MEDICARE UPIN	CALIFORNIA
4	00G238620	MEDICAID	CALIFORNIA
5	WG23862A	MEDICARE PIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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