Healthcare Provider Details

I. General information

NPI: 1992619894
Provider Name (Legal Business Name): MATTHEW JOHNSON MD APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N BEDFORD DR STE 402
BEVERLY HILLS CA
90210-4334
US

IV. Provider business mailing address

435 N BEDFORD DR STE 402
BEVERLY HILLS CA
90210-4334
US

V. Phone/Fax

Practice location:
  • Phone: 248-818-1184
  • Fax:
Mailing address:
  • Phone: 248-818-1184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MATTHEW CLARENCE JOHNSON
Title or Position: PRESIDENT
Credential: MD
Phone: 248-818-1184