MEDICARE: LONGVIEW MEDICAL INC

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
1	207RG0100X	Gastroenterology Physician	G33624	CA

General Provider Information

NPI Number	:	1508016874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONGVIEW MEDICAL INC

Provider Business Mailing Address
First Line	:	12400 VENTURA BLVD
Second Line	:	SUITE 526
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2406
Country	:	US
Telephone Number	:	818-915-3820
Fax Number	:

Provider Business Practice Location Address
First Line	:	12400 VENTURA BLVD
Second Line	:	SUITE 526
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2406
Country	:	US
Telephone Number	:	818-915-3820
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	STEVEN GRANT JOHNSON
Credential	:	MD
Telephone Number	:	818-915-3820

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	09/23/2008

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Directions to “LONGVIEW MEDICAL INC ” Practice Location

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