Individual
DR. JOHNNY T LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7345 MEDICAL CENTER DR, SUITE #280, WEST HILLS, CA 91307-1937
(818) 888-2855
(818) 888-0702
Mailing address
7345 MEDICAL CENTER DR, SUITE #280, WEST HILLS, CA 91307-1937
(818) 888-2855
(818) 888-0702
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A025311
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A253110
—
CA
01
—
953718732
CORPORATE TAX ID
CA
01
—
A025311
CA MEDICAL LICENSE
CA
01
—
Y5394
MEDICARE SUPPLIER #
CA
Enumeration date
12/22/2005
Last updated
09/23/2008
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