Individual
DEVON JACOB JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR # MC8218, SAN DIEGO, CA 92103-1911
(619) 471-0283
Mailing address
200 W ARBOR DR # MC8218, SAN DIEGO, CA 92103-1911
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A190695
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A190695
MEDICAL BOARD CA
CA
Enumeration date
05/28/2019
Last updated
12/20/2024
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