Individual
KENNETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(951) 788-3537
(951) 788-3173
Mailing address
9155 SANTA BARBARA DR, RIVERSIDE, CA 92508-6496
(951) 235-7665
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A159476
CA
Other
Enumeration date
03/22/2017
Last updated
12/19/2019
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