MEDICARE: RICHARD JOHNSON RCP

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	227800000X	Certified Respiratory Therapist	31113	CA

General Provider Information

NPI Number	:	1538439641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD JOHNSON RCP

Provider Business Mailing Address
First Line	:	9142 WOODED HILL DR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92883-9345
Country	:	US
Telephone Number	:	949-735-5363
Fax Number	:

Provider Business Practice Location Address
First Line	:	9142 WOODED HILL DR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92883-9345
Country	:	US
Telephone Number	:	949-735-5363
Fax Number	:

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

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	01/05/2012

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