Individual
DR. KENNETH WAYNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
711 W COLLEGE ST, SUITE M88, LOS ANGELES, CA 90012-1163
(213) 625-8825
(213) 625-8838
Mailing address
PO BOX 491389, LOS ANGELES, CA 90049-9389
(310) 351-1495
(866) 631-5338
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0428328
KS
208100000X
Physical Medicine & Rehabilitation Physician
2006028600
MO
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G83706
CA
Other
Enumeration date
04/28/2006
Last updated
12/10/2007
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