MEDICARE: DR. WILLIAM ROCH JOHNSTON DC

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	111N00000X	Chiropractor	DC21727	CA

General Provider Information

NPI Number	:	1982785853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ROCH JOHNSTON DC

Provider Business Mailing Address
First Line	:	18124 CULVER DR
Second Line	:	STE G UNIVERSITY PARK CHIROPRACTIC
City	:	IRVINE
State	:	CA
Zip	:	92612-2729
Country	:	US
Telephone Number	:	949-786-8802
Fax Number	:	949-786-8875

Provider Business Practice Location Address
First Line	:	18124 CULVER DRIVE
Second Line	:	SUITE G UNIVERSITY PARK CHIROPRACTIC
City	:	IRVINE
State	:	CA
Zip	:	92612-2729
Country	:	US
Telephone Number	:	949-786-8802
Fax Number	:	949-786-8875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	12/07/2011

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