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Organization
EMANUEL MEDICAL GROUP, INC.
Active
Organization
EMANUEL MEDICAL GROUP, INC.
Active
Other names
Emmanuel Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS KIRK JOHNSON M.D. (PRESIDENT/CEO)
(209) 664-5150
Entity
Organization
Contact information
Practice address
2121 COLORADO AVE, SUITE C, TURLOCK, CA 95382-2012
(209) 664-5175
(209) 669-4684
Mailing address
2121 COLORADO AVE, SUITE C, TURLOCK, CA 95382-2012
(209) 664-5175
(209) 669-4684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2854800000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275764615
—
CA
Enumeration date
08/03/2009
Last updated
10/16/2013
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