Provider Demographics
NPI:1780069294
Name:DREDGE, JUSTIN (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:DREDGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5363 BALBOA BLVD STE 545
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2854
Mailing Address - Country:US
Mailing Address - Phone:818-906-2929
Mailing Address - Fax:818-906-0567
Practice Address - Street 1:5363 BALBOA BLVD STE 545
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2854
Practice Address - Country:US
Practice Address - Phone:818-906-2929
Practice Address - Fax:818-906-0567
Is Sole Proprietor?:No
Enumeration Date:2015-07-26
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
CAA146754207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology