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General NPI Number Information
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NPI Number | 1477672046
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Entity Type | Individual
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Provider Name | RONALD M JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5360 JACKSON DRIVE STE 100
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City | LA MESA
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State | CA
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Zip | 91943
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Country | US
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Telephone | 619-462-5900
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Fax | 619-462-9899
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Provider Business Mailing Address
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Address Line | PO BOX 2507
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City | LA MESA
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State | CA
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Zip | 91943-2507
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Country | US
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Telephone | 619-462-5900
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Fax | 619-462-9899
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G19831
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License Number State | CA
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