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General NPI Number Information
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NPI Number | 1649204579
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Entity Type | Organization
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Legal Business Name | JOHNSON'S ORTHOPEDIC OF SAN DIEGO
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 02/03/2020
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Provider Practice Location Address
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Address Line | 7898 OSTROW ST STE F
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City | SAN DIEGO
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State | CA
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Zip | 92111
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Country | US
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Telephone | 858-278-0518
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Fax | 858-278-0323
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Provider Business Mailing Address
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Address Line | 7898 OSTROW ST STE F
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City | SAN DIEGO
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State | CA
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Zip | 92111
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Country | US
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Telephone | 858-278-0518
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Fax | 858-278-0323
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Authorized Official
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Title or Position | CFO
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Name | MRS. SHERRY LYNN JOHNSON
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Credential |
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Telephone | 858-278-0518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | CO2384
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License Number State | CA
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