| Doctor Name: | MARC DOUGLAS JOHNSON |
| NPI Number: | 1033251681 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A79547 |
| Business Practice Address: | 114 2 Rose Avenue Selma, CA - 93662 |
| Business Phone Number: | 5598918940 |
| Business Fax Number: | 5598918940 |
| Mailing Address: | Po Box 52060, PACIFIC GROVE |
| State: | CA |
| Postal Code: | 93950 |
| Phone Number: | 8319016856 |
| Fax Number: | |
| NPI Enumeration Date: | 02/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2083S0010X |
| License Number: | A79547 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Preventive Medicine |
| Taxonomy Specialization: | Sports Medicine |
| Taxonomy Definition: | A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |