Individual
DR. JEREMIAH NICHOLAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 STEIN PLAZA SUITE 420, LOS ANGELES, CA 90095-3905
(310) 825-5111
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A129261
CA
207T00000X
Neurological Surgery Physician
Q3898
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346356401
—
TX
Enumeration date
06/01/2007
Last updated
07/21/2021
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