Individual
DR. JUSTIN CHARLES SPOOLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11234 ANDERSON ST, LLUMC, HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354-2804
(909) 558-4000
Mailing address
11234 ANDERSON ST, LLUMC, HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354-2804
(909) 558-4000
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A100848
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962619924
—
CA
Enumeration date
05/17/2007
Last updated
11/30/2021
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