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NPI Code Detail

MEDICARE: CAMELLA JOHNSON PA

MEDICARE: CAMELLA JOHNSON PA
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 AssistantPA17177CA

General Provider Information

NPI Number : 1679589626
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMELLA JOHNSON PA
Provider Business Mailing Address
First Line : 4535 DRESSLER RD NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2545
Country : US
Telephone Number : 330-493-4443
Fax Number : 330-493-8677
Provider Business Practice Location Address
First Line : 7500 HOSPITAL DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-5403
Country : US
Telephone Number : 330-493-4443
Fax Number : 330-493-8677
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/08/2007

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Directions to “ CAMELLA JOHNSON PA” Practice Location

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