Doctor Name: | DR. RICHARD G JOHNSON |
NPI Number: | 1083691182 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | G45973 |
Business Practice Address: | 415 W Carroll Ave Glendora, CA - 917414208 |
Business Phone Number: | 6269145219 |
Business Fax Number: | 6269147846 |
Mailing Address: | 415 W Carroll Ave, GLENDORA |
State: | CA |
Postal Code: | 917414208 |
Phone Number: | 6269145219 |
Fax Number: | 6269147846 |
NPI Enumeration Date: | 12/29/2005 |
NPI Last Update Date: | 03/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G45973 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |