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General NPI Number Information
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NPI Number | 1114916053
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Entity Type | Individual
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Provider Name | ERIC WILLIAM JOHNSTON MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 477 N EL CAMINO REAL STE C202
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City | ENCINITAS
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State | CA
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Zip | 92024-1332
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Country | US
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Telephone | 760-631-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 UNION ST UNIT 1103
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City | SAN DIEGO
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State | CA
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Zip | 92101-3445
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Country | US
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Telephone | 312-498-4301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C169344
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License Number State | CA
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