Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JUSTIN KEADLE, PA-C
ActiveMR. JUSTIN KEADLE, PA-C is a Surgical Physician Assistant healthcare provider located in SAN LUIS OBISPO, California. NPI 1801210026 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · SAN LUIS OBISPO, CA
Registration Details
- NPI Number
- 1801210026
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 7, 2014 (12.333415044748 yrs)
- Last Updated
- Sep 22, 2016
- Licenses
-
C05327 (MD)PA53511 (CA)
Practice Information
- Address
-
1010 MURRAY AVESAN LUIS OBISPO, CA, 934051806Browse CA providers · Browse ZIP 93405
- Phone
- 8055461997
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.