Individual
JARED JOSHUA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10601 PARAMOUNT BLVD, DOWNEY, CA 90241-3303
(562) 923-7257
Mailing address
2254 N 4TH AVE, UPLAND, CA 91784-8400
(909) 568-8777
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
105919
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2020
Last updated
08/15/2024
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