Individual
DR. JIMMY JOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3828 SCHAUFELE AVE STE 200, LONG BEACH, CA 90808-1793
(657) 241-8990
(714) 665-4600
Mailing address
17360 BROOKHURST ST, ATTN: CREDENTIALING DEPARTMENT, FOUNTAIN VALLEY, CA 92708-3720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
CA119213
CA
207RP1001X
Pulmonary Disease Physician
Primary
CA119213
CA
Other
Enumeration date
01/05/2011
Last updated
07/03/2019
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