Johnson, Richard G
Johnson, Richard G is an individual health care provider with primary practice located at 415 W Carroll Ave , Glendora CA 91741-4208. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Johnson, Richard G can be contacted via phone (626) 914-5219.Contact Information
Primary practice address
415 W Carroll Ave
Glendora CA 91741-4208
Phone: (626) 914-5219
Fax: (626) 914-7846
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G45973 | California |
Profile Details
| NPI number | 1083691182 |
|---|---|
| LBN Legal business name | Johnson, Richard G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Mar 25th, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083691182 | NPPES |
| California | MEDICAID | 00G459730 |
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