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General NPI Number Information
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NPI Number | 1073070942
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Entity Type | Organization
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Legal Business Name | DOCTOR JOHNSONS URGENT CARE MEDICAL CLINIC INC
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Dates
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Enumeration Date | 02/26/2019
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 517 E WILSON AVE STE 103B
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City | GLENDALE
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State | CA
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Zip | 91206
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Country | US
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Telephone | 747-515-6068
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Fax |
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Provider Business Mailing Address
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Address Line | 517 E WILSON AVE STE 103B
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City | GLENDALE
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State | CA
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Zip | 91206
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Country | US
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Telephone | 747-515-6068
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Fax |
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Authorized Official
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Title or Position | INTERNAL MEDICINE
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Name | THOMAS DOSUMU-JOHNSON
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Credential | MD
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Telephone | 562-733-9789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number |
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License Number State |
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