Individual
WALTER D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25455 BARTON RD, SUITE 108A, LOMA LINDA, CA 92354-3128
(909) 558-6388
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G84949
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G849490
—
CA
Enumeration date
06/28/2006
Last updated
07/14/2008
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