Individual
CRAIG MARSHALL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1000
Mailing address
444 S EUREKA ST, REDLANDS, CA 92373-5908
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
795907
CA
367500000X
Certified Registered Nurse Anesthetist
121027
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95000907
CA
Other
Enumeration date
02/23/2018
Last updated
09/26/2018
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