JUSTINA AZCUETA — OIG Excluded Provider (SAN JOSE, CA, 1128b14)
JUSTINA AZCUETA — OIG Excluded Provider (SAN JOSE, CA, 1128b14) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: JUSTINA AZCUETA; Type: Individual; Provider category: IND- LIC HC SERV PRO.
| Name | JUSTINA AZCUETA |
|---|---|
| Type | Individual |
| Provider category | IND- LIC HC SERV PRO |
| Specialty | DENTIST |
| NPI | 1619017449 |
| City | SAN JOSE |
| State | CA |
| ZIP | 95112 |
| Exclusion authority | 1128b14 |
| Exclusion reason | Default on health education loan or scholarship obligations |
| Exclusion date | 2013-03-20 |
| Source | HHS-OIG LEIE |
$1499/mo
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