Individual
DR. JOHNNIE HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1677 SHELL BEACH RD STE 101, SHELL BEACH, CA 93449-1930
(805) 201-9135
(805) 201-9134
Mailing address
1677 SHELL BEACH RD STE 101, SHELL BEACH, CA 93449-1930
(805) 201-9135
(805) 201-9134
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A90443
CA
208D00000X
General Practice Physician
A90443
CA
Other
Enumeration date
11/29/2005
Last updated
04/26/2019
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