JUSTIN MIKESELL

THOUSAND OAKS, CA
NPI1649991720
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  61471)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2022-09-07
Last Update Date2022-09-07
Business Address
JUSTIN MIKESELL
3095 OLD CONEJO RD STE 200
THOUSAND OAKS, CA 91320-2130
Phone number: 805-298-7034
Mailing Address
JUSTIN MIKESELL
2012 S PUMP HOUSE LN
SANTA PAULA, CA 93060-8024
Phone number: