Individual
DR. JUSTIN LEE MASSENGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7300 N FRESNO ST, FRESNO, CA 93720-2941
(559) 448-4000
Mailing address
7300 N FRESNO ST, FRESNO, CA 93720-2941
(559) 448-4000
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
238944
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110082708A
—
MA
Enumeration date
11/09/2007
Last updated
03/05/2025
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