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General NPI Number Information
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NPI Number | 1063713121
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Entity Type | Organization
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Legal Business Name | WARREN M JOHNSON D.P.M., INC.
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 1800 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94538-1712
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Country | US
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Telephone | 510-794-6633
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Fax | 510-794-6637
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Provider Business Mailing Address
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Address Line | 1800 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94538-1712
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Country | US
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Telephone | 510-794-6633
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Fax | 510-794-6637
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Authorized Official
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Title or Position | OWNER
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Name | WARREN M JOHNSON
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Credential | M.D.
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Telephone | 510-794-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 000E12850
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License Number State | CA
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