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NPI Code Detail

MEDICARE: DANNY JOHNSON PAC

MEDICARE: DANNY JOHNSON PAC
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
1363A00000XPhysician AssistantPA665NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235102500
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANNY JOHNSON PAC
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-877-5153
Fax Number : 702-363-8753
Provider Business Practice Location Address
First Line : 7061 GRAND MONTECITO PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-0287
Country : US
Telephone Number : 702-243-8500
Fax Number : 702-363-8753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 06/20/2024

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Directions to “ DANNY JOHNSON PAC” Practice Location

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