Healthcare Provider Details

I. General information

NPI: 1578406633
Provider Name (Legal Business Name): NICHOLAS JOHNSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 WILSHIRE BLVD STE 250
BEVERLY HILLS CA
90212-3429
US

IV. Provider business mailing address

9150 WILSHIRE BLVD STE 250
BEVERLY HILLS CA
90212-3429
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-9968
  • Fax: 310-861-1374
Mailing address:
  • Phone: 310-271-9968
  • Fax: 310-861-1374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: