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General NPI Number Information
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NPI Number | 1598039505
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Entity Type | Organization
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Legal Business Name | STANCIL E.D. JOHNSON, M.D, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | JUNIPERO ST BTWN 4TH & 5TH ST SUITE 4
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City | CARMEL
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State | CA
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Zip | 93920
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Country | US
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Telephone | 831-625-2626
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Fax | 831-625-1245
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Provider Business Mailing Address
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Address Line | P.O. BOX 5396 CARMEL POST OFFICE
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City | CARMEL
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State | CA
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Zip | 93921
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Country | US
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Telephone | 831-625-2626
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Fax | 831-625-1245
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Authorized Official
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Title or Position | DOCTOR, M.D.
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Name | DR. STANCIL E.D. JOHNSON
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Credential | M.D.
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Telephone | 831-625-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C28935
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C289350-CA
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License Number State | CA
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