Individual
CLEMENT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 S GOLDEN WEST AVE, SANTA ANA, CA 92704-2816
(714) 417-0311
Mailing address
3760 W MCFADDEN AVE # B-164, SANTA ANA, CA 92704-1392
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
CPT00005469
CA
374700000X
Technician
Primary
CPT00005469
CA
Other
Enumeration date
05/14/2019
Last updated
05/16/2019
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