Individual
JUSTIN RICHARD LANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
931 10TH ST STE 776, MODESTO, CA 95354-2305
(832) 489-3172
Mailing address
723 TANNER CT, MERCED, CA 95341-8905
(714) 722-3015
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-24-373536
CA
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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