Individual
THOMAS L JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9100 S SEPULVEDA BLVD STE 121, LOS ANGELES, CA 90045-4849
(310) 674-6785
(310) 674-2161
Mailing address
9100 S SEPULVEDA BLVD STE 121, LOS ANGELES, CA 90045-4849
(310) 674-6785
(310) 674-2161
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
C41044
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C410441
—
CA
Enumeration date
11/13/2006
Last updated
10/03/2019
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