Provider Demographics
NPI:1689786873
Name:SHERFEY, JUSTIN J (DO)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:J
Last Name:SHERFEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42135 10TH ST W STE 101
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-7099
Mailing Address - Country:US
Mailing Address - Phone:661-726-5005
Mailing Address - Fax:662-726-5377
Practice Address - Street 1:42135 10TH ST W STE 101
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7099
Practice Address - Country:US
Practice Address - Phone:661-726-5005
Practice Address - Fax:661-726-5377
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001966207X00000X
CA20A13540207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8419236Medicaid
8852629Medicare ID - Type Unspecified
WA8419236Medicaid