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NPI Code Detail

MEDICARE: DR. DOUGLAS LEE JOHNSTON PHARM.D.

MEDICARE: DR. DOUGLAS LEE JOHNSTON PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist30420CA
2183500000XPharmacistPH00060969WA
3183500000XPharmacist16583NV
4183500000XPharmacist17051CO

General Provider Information

NPI Number : 1043387103
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS LEE JOHNSTON PHARM.D.
Provider Business Mailing Address
First Line : 15204 VICTORY WAY
Second Line :
City : SONORA
State : CA
Zip : 95370-8876
Country : US
Telephone Number : 209-532-8326
Fax Number : 209-533-9489
Provider Business Practice Location Address
First Line : 1330 ENCLAVE PKWY
Second Line :
City : HOUSTON
State : TX
Zip : 77077-2025
Country : US
Telephone Number : 800-222-2005
Fax Number : 209-533-9489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 09/11/2025

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