MEDICARE: MRS. TULANI AIN JOHNSON PA-C

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	363A00000X	Physician Assistant	PA54077	CA

General Provider Information

NPI Number	:	1508049719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TULANI AIN JOHNSON PA-C

Provider Business Mailing Address
First Line	:	15411 SWAN CREEK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2017
Country	:	US
Telephone Number	:	833-246-6363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 6TH AVE STE 521
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-5209
Country	:	US
Telephone Number	:	833-246-6363
Fax Number	:

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

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	10/29/2025

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