Provider Demographics
NPI:1053650341
Name:ARNOLD, JUSTIN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:DAVID
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF DERMATOLOGY ADMINISTRATIVE OFFICE
Mailing Address - Street 2:118 MEDICAL SURGE I
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92697-2400
Mailing Address - Country:US
Mailing Address - Phone:949-824-5515
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF DERMATOLOGY ADMINISTRATIVE OFFICE
Practice Address - Street 2:118 MEDICAL SURGE I
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92697-2400
Practice Address - Country:US
Practice Address - Phone:949-824-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA176420207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology