Individual
DR. AVERY WILLIAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1145 STURGIS RD, TWENTYNINE PALMS, CA 92278
(760) 830-2190
Mailing address
1145 STURGIS RD, TWENTYNINE PALMS, CA 92278
(760) 830-2190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101275950
VA
208D00000X
General Practice Physician
Primary
0101275950
VA
Other
Enumeration date
02/17/2021
Last updated
07/15/2026
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