Provider Demographics
NPI:1891885653
Name:BAILEY, MICHAEL JUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JUSTIN
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 19989
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92159-0989
Mailing Address - Country:US
Mailing Address - Phone:619-641-6311
Mailing Address - Fax:619-641-6322
Practice Address - Street 1:3111 CAMINO DEL RIO N
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-5720
Practice Address - Country:US
Practice Address - Phone:619-641-6311
Practice Address - Fax:619-641-6322
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG563342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry