Organization
DIANE L. JOHNSON M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE L. JOHNSON M.D. (PRESIDENT)
(714) 402-4685
Entity
Organization
Contact information
Practice address
65 PINE AVE, SUITE 19, LONG BEACH, CA 90802-4718
(714) 402-4685
(562) 856-0389
Mailing address
65 PINE AVE, SUITE 19, LONG BEACH, CA 90802-4718
(714) 402-4685
(562) 856-0389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G62317
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
G62317
CA
207RP1001X
Pulmonary Disease Physician
G62317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013962273
INDIV . NPI
CA
Enumeration date
04/28/2009
Last updated
04/28/2009
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