Organization
PENNY LANE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LESTER JOHNSON (CHILD AND FAMILY SPECIALIST)
(661) 274-4883
Entity
Organization
Contact information
Practice address
190 SIERRA CT, PALMDALE, CA 93550-7607
(661) 274-4883
(661) 272-1005
Mailing address
190 SIERRA CT, PALMDALE, CA 93550-7607
(661) 274-4883
(661) 272-1005
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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