Doctor Name: | JUSTIN EDWARD LAUBACH |
NPI Number: | 1437326691 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 134536 |
Business Practice Address: | 555 E Valley Pkwy Escondido, CA - 920253048 |
Business Phone Number: | 7607393470 |
Business Fax Number: | 7607392926 |
Mailing Address: | 16955 Via Del Campo, Suite 215 SAN DIEGO |
State: | CA |
Postal Code: | 921277720 |
Phone Number: | 8586736100 |
Fax Number: | 8586736113 |
NPI Enumeration Date: | 05/15/2008 |
NPI Last Update Date: | 08/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 134536 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |