Individual
ANDREW W JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MMS, PA-C
Contact information
Practice address
3151 AIRWAY AVE STE G1, COSTA MESA, CA 92626-4624
(714) 545-5550
Mailing address
341 MONTE VISTA AVE, COSTA MESA, CA 92627-1460
(619) 756-4112
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA59223
CA
363AM0700X
Medical Physician Assistant
Primary
59223
CA
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
01/12/2021
Last updated
01/08/2025
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