Individual
NEIL GRANT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18300 US HIGHWAY 18, ST. MARY MEDICAL CENTER, APPLE VALLEY, CA 92307-2206
(909) 881-6427
(909) 880-8708
Mailing address
PO BOX 9160, SAN BERNARDINO, CA 92427-0160
(909) 881-6427
(909) 887-8708
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G20232
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G202320
—
CA
Enumeration date
09/09/2005
Last updated
03/05/2008
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