Johnson, Michael Wayne

Johnson, Michael Wayne is an sole proprietor health care provider with primary practice located at 5777 Greenback Ln Ste. 100, Sacramento CA 95841-2013. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, Michael Wayne can be contacted via phone (916) 231-0034.

Contact Information

Primary practice address
5777 Greenback Ln Ste. 100 Sacramento CA 95841-2013
Phone: (916) 231-0034
Fax: (916) 231-0038
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 10133T California

Profile Details

NPI number 1972583391
LBN Legal business name Johnson, Michael Wayne
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 20th, 2006
Last updated Jul 31st, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972583391 NPPES
California MEDICAID SD0101330

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