Individual
MR. WAVERLY JOHNSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1726 E. 117TH ST., LOS ANGELES, CA 90059
(323) 566-1965
Mailing address
6002 5TH AVE, LOS ANGELES, CA 90043-4212
(323) 778-0223
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
CA
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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