Individual
MR. TREVOR RUSSELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTC
Contact information
Practice address
320 SANTA FE DR STE 301, ENCINITAS, CA 92024-5140
(760) 633-4700
(760) 635-4344
Mailing address
6619 BELL BLUFF AVE, SAN DIEGO, CA 92119-1148
(619) 746-9194
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
OTC 09-0802
—
Other
Enumeration date
10/26/2009
Last updated
10/26/2009
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