Individual
MICHAEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1270 W 80TH ST, LOS ANGELES, CA 90044-2310
(323) 338-6103
Mailing address
1270 W 80TH ST, LOS ANGELES, CA 90044-2310
(323) 338-6103
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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