Healthcare Provider Details

I. General information

NPI: 1477581866
Provider Name (Legal Business Name): SEAN L JOHNSTON M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2414 S FAIRVIEW ST STE 202B
SANTA ANA CA
92704-5318
US

IV. Provider business mailing address

631 COUNTRY CLUB DR
BURBANK CA
91501-1121
US

V. Phone/Fax

Practice location:
  • Phone: 805-300-6761
  • Fax:
Mailing address:
  • Phone: 818-416-5037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA73716
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberA73716
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA73716
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA73716
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberA73716
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number49574
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberA73716
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberA73716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: