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Individual

DR. MARK YARWOOD JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
480 4TH AVE, SUITE 506, CHULA VISTA, CA 91910-4410
(619) 585-0313
(619) 585-0037
Mailing address
65 CATSPAW CPE, CORONADO, CA 92118-3221
(619) 585-0313
(619) 585-0037

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G28163
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G281630
CA
01
100001724
MEDICARE RAILROAD
CA
01
A43635
UPIN
CA
Enumeration date
06/30/2006
Last updated
10/04/2007
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