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General NPI Number Information
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NPI Number | 1659180636
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Entity Type | Individual
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Provider Name | CONNER JOHNSON DPT, PT
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Gender | Male
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 2855 CARLSBAD BLVD
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City | CARLSBAD
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State | CA
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Zip | 92008-2902
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Country | US
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Telephone | 800-255-1556
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Fax |
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Provider Business Mailing Address
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Address Line | 4164 CAMINO CAMPANA
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City | OCEANSIDE
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State | CA
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Zip | 92057-3550
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Country | US
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Telephone | 209-597-2185
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 307142
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License Number State | CA
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