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General NPI Number Information
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NPI Number | 1952854010
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Entity Type | Individual
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Provider Name | MATTHEW ANDREW JOHNSON AU.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2016
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 9961 SIERRA AVE AUDIOLOGY, BUILDING 3, FLOOR 2
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City | FONTANA
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State | CA
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Zip | 92335-6720
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Country | US
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Telephone | 909-427-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 13637 DELAWARE RD
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City | APPLE VALLEY
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State | CA
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Zip | 92308-6182
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Country | US
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Telephone | 760-247-8097
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3144
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License Number State | CA
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