Individual
BERT JAY JOHNS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 SULLIVAN AVE, SUITE 507, DALY CITY, CA 94015-2225
(650) 994-9936
(650) 994-2016
Mailing address
1800 SULLIVAN AVE, SUITE 507, DALY CITY, CA 94015-2225
(650) 994-9936
(650) 994-2016
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G62546
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G625460
—
CA
Enumeration date
12/05/2005
Last updated
04/29/2009
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