Individual
JUSTIN MICHAEL GRECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MB BCH BAO
Contact information
Practice address
11175 CAMPUS ST STE 21111, LOMA LINDA, CA 92350-3220
(909) 651-1000
Mailing address
11175 CAMPUS ST STE 21111, LOMA LINDA, CA 92350-1700
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
A196598
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/10/2018
Last updated
09/23/2024
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