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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972583391 | NPPES |
| California | MEDICAID | SD0101330 |
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