Individual
MICHAEL JOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34 MARK WEST SPRINGS RD, SANTA ROSA, CA 95403-1766
(707) 573-5200
(707) 573-5417
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 573-5200
(707) 573-5417
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A140871
CA
207RC0000X
Cardiovascular Disease Physician
Primary
1126262
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A140871
STATE MEDICAL LICENSE
CA
Enumeration date
04/26/2014
Last updated
08/12/2022
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