Individual
MR. GARY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1539 W AVENUE L12, LANCASTER, CA 93534-6930
(661) 948-1275
(661) 902-6985
Mailing address
1539 W AVENUE L12, LANCASTER, CA 93534-6930
(661) 948-1275
(661) 902-6985
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
197605271
CA
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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