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Organization
RICHARD G JOHNSON MD INC
Active
Organization
RICHARD G JOHNSON MD INC
Active
Other names
richard g johnson md inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD GREENE JOHNSON M.D. (OWNER)
(626) 914-5219
Entity
Organization
Contact information
Practice address
415 W CARROLL AVE, STE 100, GLENDORA, CA 91741-4208
(626) 914-5219
(626) 914-7846
Mailing address
415 W CARROLL AVE, STE 100, GLENDORA, CA 91741-4208
(626) 914-5219
(626) 914-7846
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G45973
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A464880
—
CA
05
—
00A466040
—
CA
05
—
00A616960
—
CA
05
—
00G459730
—
CA
01
—
110086507
RAILROAD MEDICARE
CA
01
—
WA46488F
INDIVIDUAL MEDICARE ID
CA
01
—
WA46604A
INDIVIDUAL MEDICARE ID
CA
01
—
WA61696A
INDIVIDUAL MEDICARE ID
CA
01
—
WG45973E
INDIVIDUAL MEDICARE ID
CA
Enumeration date
07/21/2006
Last updated
02/10/2009
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