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General NPI Number Information
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NPI Number | 1831355650
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Entity Type | Individual
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Provider Name | BRIAN LEE JOHNSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 4601 DALE RD
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City | MODESTO
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State | CA
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Zip | 95356-9718
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Country | US
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Telephone | 209-735-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 3402 DEWAR LN
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City | TURLOCK
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State | CA
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Zip | 95382-9670
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Country | US
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Telephone | 209-667-4760
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 56142
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License Number State | CA
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