Individual
ROBERT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6435 LAGO CIR, RANCHO MURIETA, CA 95683-9249
(916) 342-5919
Mailing address
6435 LAGO CIR, RANCHO MURIETA, CA 95683-9249
(916) 342-5919
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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