Individual
KENNETH BURTON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
769 MEDICAL CENTER CT, SUITE 202, CHULA VISTA, CA 91911-6660
(619) 482-8430
(619) 482-8005
Mailing address
769 MEDICAL CENTER CT, SUITE 202, CHULA VISTA, CA 91911-6660
(619) 482-8430
(619) 482-8005
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A79802
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0100450
—
CA
Enumeration date
08/21/2006
Last updated
07/19/2012
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