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NPI Code Detail

MEDICARE: DR. MARILYN JOHNSON D.C.

MEDICARE:  DR. MARILYN  JOHNSON  D.C.
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
1111N00000XChiropractorDC 26880CA

General Provider Information

NPI Number : 1992031033
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARILYN JOHNSON D.C.
Provider Business Mailing Address
First Line : 1911 LAKE AVE
Second Line :
City : ALTADENA
State : CA
Zip : 91001-3037
Country : US
Telephone Number : 323-828-8111
Fax Number :
Provider Business Practice Location Address
First Line : 1911 LAKE AVE
Second Line :
City : ALTADENA
State : CA
Zip : 91001-3037
Country : US
Telephone Number : 323-828-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2009
Last Update Date : 10/25/2009

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Directions to “ DR. MARILYN JOHNSON D.C.” Practice Location

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