Individual
JOAQUIN FUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 MEDICAL PLZ, LOS ANGELES, CA 90095-0001
(310) 825-9989
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-9989
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A23213
CA
2084P0804X
Child & Adolescent Psychiatry Physician
A23213
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A232130
—
CA
Enumeration date
08/11/2006
Last updated
04/26/2012
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