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General NPI Number Information
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NPI Number | 1932736501
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Entity Type | Individual
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Provider Name | RILEY JOHNSON MD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 11370 ANDERSON ST STE 2100
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City | LOMA LINDA
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State | CA
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Zip | 92354-3450
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Country | US
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Telephone | 909-651-9863
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Fax |
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Provider Business Mailing Address
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Address Line | 2609 S 138TH ST
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City | SEATAC
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State | WA
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Zip | 98168-3861
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Country | US
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Telephone | 719-221-5138
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 201757
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | WA
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