Individual
DANNY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
7061 GRAND MONTECITO PKWY, LAS VEGAS, NV 89149-0287
(702) 243-8500
(702) 363-8753
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5153
(702) 363-8753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA665
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102514
—
NV
01
—
3102574
MEDICAID
NV
Enumeration date
02/08/2006
Last updated
06/20/2024
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