Organization
HELEN V & FRED JOHNSON
Active
Other names
Lake County Anesthesia Medical Asso
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK L JOHNSON M.D. (PRESIDENT)
(818) 550-0900
Entity
Organization
Contact information
Practice address
5176 HILL RD E, LAKEPORT, CA 95453-6300
(707) 262-5000
Mailing address
PO BOX 951, GLENDALE, CA 91209-0951
(818) 550-0900
(818) 550-0909
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071440
—
CA
01
—
ZZZ60330Z
BLUE SHIELD
CA
Enumeration date
02/11/2007
Last updated
06/30/2008
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