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MR. JUSTIN TYLER GOODRO NPI 1770002297


NPI Information

NPI: 1770002297
Provider Name: MR. JUSTIN TYLER GOODRO
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
2008 N GAREY AVE
POMONA, CA
ZIP 91767
Phone: (909) 242-7640
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MR. Justin Tyler Goodro is a student in an organized health care education training program in Pomona, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. MR. Justin Tyler Goodro NPI is 1770002297. 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:

2008 N GAREY AVE
POMONA, CA
ZIP 91767-722
Phone: (909) 242-7640

The enumeration date for this NPI number is 9/15/2017 and was last updated on 9/15/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramCALIFORNIAYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.