Individual
DEREK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
350 JOHN MUIR PKWY STE 105, BRENTWOOD, CA 94513-5183
(925) 513-2483
(925) 513-4957
Mailing address
2350 W EL CAMINO REAL FL 2, MOUNTAIN VIEW, CA 94040-6203
(925) 513-2483
(925) 513-4957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A8220
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX82200
—
CA
01
—
20A8220
STATE MEDICAL LICENSE
CA
Enumeration date
07/19/2006
Last updated
03/07/2023
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