Organization
JOHNSON'S ORTHOPEDIC
Active
Other names
Johnson's Orthopedic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LESLI D. KEARNEY (CFO)
(951) 785-4411
Entity
Organization
Contact information
Practice address
24335 PRIELIPP RD, SUITE 118, WILDOMAR, CA 92595-7426
(877) 483-2522
(951) 785-4665
Mailing address
7254 MAGNOLIA AVE, RIVERSIDE, CA 92504-3829
(951) 785-4411
(951) 785-4665
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487748059
MEDI-CAL
CA
Enumeration date
11/19/2008
Last updated
11/19/2008
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