Individual
JOHNY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-1900
(732) 776-4798
Mailing address
1945 STATE ROUTE 33, NEPTUNE, NJ 07754
(732) 776-4483
(732) 776-4798
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A158595
CA
Other
Enumeration date
04/30/2015
Last updated
06/25/2019
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