Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Justin La, MD

Individual provider Urology Physician · NPI 1063867513

Dr. Justin La, MD is an Urology in San Rafael, California. Graduated from Medical College of Wisconsin in 2012, 14 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
14
Trained at
Medical College of Wisconsin
Licensed in
CA
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

99 Montecillo Rd
San Rafael, CA 94903-3308
Phone: (415) 444-2919
Fax: (415) 444-2328
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence A152841 (CA)

Record details

NPI number1063867513
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 3, 2016
Last updated in NPPESAugust 30, 2022
Certification dateAugust 30, 2022
Mailing address99 Montecillo Rd, San Rafael, CA 94903-3308

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2012 (14 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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