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NPI Code Detail

MEDICARE: DR. ROBERT CULLEN JOHNSTON O.D.

MEDICARE:  DR. ROBERT CULLEN JOHNSTON  O.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
1152W00000XOptometrist10220TCA

General Provider Information

NPI Number : 1568501625
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT CULLEN JOHNSTON O.D.
Provider Business Mailing Address
First Line : 4598 AVENIDA MANESSA
Second Line :
City : OCEANSIDE
State : CA
Zip : 92057-7745
Country : US
Telephone Number : 760-631-2877
Fax Number :
Provider Business Practice Location Address
First Line : 705 COLLEGE BLVD
Second Line :
City : OCEANSIDE
State : CA
Zip : 92057-6259
Country : US
Telephone Number : 760-631-2877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2007
Last Update Date : 07/08/2007

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Directions to “ DR. ROBERT CULLEN JOHNSTON O.D.” Practice Location

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