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NPI Code Detail

MEDICARE: DR. RONALD ARTHUR JOHANSON M.D.

MEDICARE: DR. RONALD ARTHUR JOHANSON M.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
1207Q00000XFamily Medicine PhysicianA34086CA

General Provider Information

NPI Number : 1134153299
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD ARTHUR JOHANSON M.D.
Provider Business Mailing Address
First Line : 1701 SYLVIA CT
Second Line :
City : TURLOCK
State : CA
Zip : 95382-2829
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 911 E TUOLUMNE RD
Second Line :
City : TURLOCK
State : CA
Zip : 95382-1543
Country : US
Telephone Number : 209-668-4101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/08/2007

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