Organization
DIANE L. JOHNSON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE L. JOHNSON M.D. (PRESIDENT, MEDICAL DIRECTOR)
(714) 402-4685
Entity
Organization
Contact information
Practice address
2131 W 3RD ST, LOS ANGELES, CA 90057-1901
(213) 484-7111
(213) 207-5620
Mailing address
65 PINE AVE, LONG BEACH, CA 90802-4718
(714) 402-4685
(818) 462-0991
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
G62317
CA
208M00000X
Hospitalist Physician
G62317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G62317
LICENSE NUMBER
CA
Enumeration date
08/08/2008
Last updated
08/08/2008
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