Individual
DR. MICHAEL ALAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
108 LYNCH CREEK WAY, SUITE 3, PETALUMA, CA 94954
(707) 763-2253
(707) 763-7030
Mailing address
108 LYNCH CREEK WAY, SUITE 3, PETALUMA, CA 94954
(707) 763-2253
(707) 763-7030
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3671
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E36712
MEDICAL
CA
05
—
000E36712
—
CA
01
—
480027344
RAILROAD MEDICARE
CA
Enumeration date
08/11/2006
Last updated
11/03/2021
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