MEDICARE: DR. SEAN L JOHNSTON M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	A73716	CA
2	2085R0203X	Therapeutic Radiology Physician	A73716	CA
3	2085R0202X	Diagnostic Radiology Physician	A73716	CA
4	2085B0100X	Body Imaging Physician	A73716	CA
5	2085N0700X	Neuroradiology Physician	A73716	CA
6	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist	49574	CA
7	2085P0229X	Pediatric Radiology Physician	A73716	CA
8	2085U0001X	Diagnostic Ultrasound Physician	A73716	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A73716	OTHER	CA	MEDICAL LIC

General Provider Information

NPI Number	:	1477581866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN L JOHNSTON M.D., PH.D.

Provider Business Mailing Address
First Line	:	631 COUNTRY CLUB DR
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91501-1121
Country	:	US
Telephone Number	:	818-416-5037
Fax Number	:

Provider Business Practice Location Address
First Line	:	2414 S FAIRVIEW ST STE 202B
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5318
Country	:	US
Telephone Number	:	805-300-6761
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	05/18/2026

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Directions to “ DR. SEAN L JOHNSTON M.D., PH.D.” Practice Location

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