Physician Assistant
JUSTIN BLACKMON
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1699182832 · enumerated 2014-07-21 · record updated 2016-10-31. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Mailing address 4818 GLENDARION DR, DURHAM, NC, 27713-8025 Google Maps Apple Maps OpenStreetMap
- Practice location 9888 GENESEE AVE, LA JOLLA, CA, 92037-1205 (858) 626-4123 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant 363A00000X · License PA031058 DC
- Physician Assistant, Medical 363AM0700X · License 085.005596 IL
- Physician Assistant 363A00000X · Primary · License 53958 CA
In this directory
Locations and evidence
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Practice location
LA JOLLA, CA, 920371205
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.