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Organization
JENNIFER JOHNSON, M.D., A PROFESSIONAL CORPORATION
Active
Organization
JENNIFER JOHNSON, M.D., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JOHNSON M.D. (CEO)
(949) 856-2701
Entity
Organization
Contact information
Practice address
366 SAN MIGUEL DR STE 209, NEWPORT BEACH, CA 92660-7810
(949) 856-2701
Mailing address
366 SAN MIGUEL DR STE 209, NEWPORT BEACH, CA 92660-7810
(949) 856-2701
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A40753
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982648192
NPID
CA
Enumeration date
07/03/2015
Last updated
07/03/2015
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