Healthcare Provider Details

I. General information

NPI: 1689645525
Provider Name (Legal Business Name): CHRISTINE LEIGH JOHNSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 GIRARD AVE STE 106
LA JOLLA CA
92037-5138
US

IV. Provider business mailing address

7300 GIRARD AVE STE 106
LA JOLLA CA
92037-5138
US

V. Phone/Fax

Practice location:
  • Phone: 858-459-4351
  • Fax: 858-459-4399
Mailing address:
  • Phone: 858-459-4351
  • Fax: 858-459-4399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number134838
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: