Individual
MR. CHARLES MILLER JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
1020 ROBINSON AVE APT 2, SAN DIEGO, CA 92103-4473
(619) 581-4410
Mailing address
1020 ROBINSON AVE APT 2, SAN DIEGO, CA 92103-4473
(619) 581-4410
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300231
NY
164X00000X
Licensed Vocational Nurse
VN251826
CA
Other
Enumeration date
02/08/2010
Last updated
02/03/2014
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