Individual
EARL D. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
769 19TH ST, OAKLAND, CA 94612-1014
(510) 834-4553
(510) 834-4502
Mailing address
769 19TH ST, OAKLAND, CA 94612-1014
(510) 834-4553
(510) 834-4502
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
A0303486
CA
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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