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Organization
OCEANSIDE MEDICAL GROUP, A MEDICAL CORPORATION
Active
Organization
OCEANSIDE MEDICAL GROUP, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GADSON J JOHNSON M.D. (PRESIDENT)
(310) 993-4103
Entity
Organization
Contact information
Practice address
701 SANTA MONICA BLVD, SUITE 230, SANTA MONICA, CA 90401-2623
(310) 993-4103
(805) 494-8385
Mailing address
701 SANTA MONICA BLVD, SUITE 230, SANTA MONICA, CA 90401-2623
(310) 993-4103
(805) 494-8385
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FNP41555
FNP
CA
Enumeration date
07/29/2011
Last updated
07/29/2011
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