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General NPI Number Information
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NPI Number | 1841245057
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Entity Type | Individual
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Provider Name | RANDALL LEE JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 4081 EAST OLYMPIC BOULEVARD
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City | LOS ANGELES
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State | CA
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Zip | 90023-3330
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Country | US
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Telephone | 323-881-2666
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Fax | 323-267-4530
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Provider Business Mailing Address
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Address Line | 2550 NORTH HOLLYWOOD WAY SUITE 209
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City | BURBANK
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State | CA
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Zip | 91505-5019
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Country | US
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Telephone | 818-557-0135
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Fax | 818-557-1394
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | G34657
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License Number State | CA
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