Individual
IAN TODD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
45 E RIVER PARK PL W, SUITE 104, FRESNO, CA 93720-1562
(559) 320-0530
(559) 320-0532
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A114456
CA
207T00000X
Neurological Surgery Physician
ME108492
FL
Other
Enumeration date
10/17/2006
Last updated
06/30/2014
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