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NPI Code Detail

MEDICARE: DANIEL STEVEN JOHNSON PA-C, L.AC.

MEDICARE: DANIEL STEVEN JOHNSON PA-C, L.AC.
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
1171100000XAcupuncturistAC 9587CA
2363AM0700XMedical Physician AssistantPA21442CA

General Provider Information

NPI Number : 1508151572
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL STEVEN JOHNSON PA-C, L.AC.
Provider Business Mailing Address
First Line : 100 WILSON RD STE 100
Second Line :
City : MONTEREY
State : CA
Zip : 93940-7885
Country : US
Telephone Number : 831-649-1000
Fax Number :
Provider Business Practice Location Address
First Line : 1505 MAIN ST
Second Line :
City : WATSONVILLE
State : CA
Zip : 95076-3761
Country : US
Telephone Number : 831-722-1444
Fax Number : 831-722-4414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2011
Last Update Date : 05/10/2018

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