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

Dr. Justin Michael Bennink, MD

Individual provider Family Medicine Physician · NPI 1083033146

Dr. Justin Michael Bennink, MD is a Family Practice in San Ysidro, California. Graduated from University of California, Irvine, California College of Medicine in 2014, 12 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
12
Trained at
University of California, Irvine, California College of Medicine
Licensed in
CA
In the registry since
2014
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

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone: (619) 662-4100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A138477 (CA)

Record details

NPI number1083033146
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 15, 2014
Last updated in NPPESDecember 6, 2021

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in San Ysidro