Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A143235 | CA |
N | 208800000X | Urologist | DR.0063344 | CO |
NPI | 1053794016 |
---|---|
Provider Name | Justin Joseph Houman |
First Address | Los Angeles, CA 90048-6101 |
Second Address | Los Angeles, CA 90048-6101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2015 |
Last Update Date | 06/11/2019 |