Organization
KENNETH S JOHNSON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH S JOHNSON M.D. (OWNER)
(562) 407-2080
Entity
Organization
Contact information
Practice address
18685 MAIN ST # A, SUITE 600, HUNTINGTON BEACH, CA 92648-1723
(562) 407-2080
Mailing address
PO BOX 4259, CERRITOS, CA 90703-4259
(562) 407-2080
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A43322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A433223
—
CA
Enumeration date
10/18/2006
Last updated
05/19/2008
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