Johnson, Craig R

Johnson, Craig R is an individual health care provider with primary practice located at 960 E Green St Suite 292, Pasadena CA 91106-2401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Craig R can be contacted via phone (626) 449-4494.

Contact Information

Primary practice address
960 E Green St Suite 292 Pasadena CA 91106-2401
Phone: (626) 449-4494
Fax: (626) 449-4474
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G72241 California

Profile Details

NPI number 1336191063
LBN Legal business name Johnson, Craig R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jan 27th, 2010 - about 16 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 1336191063 NPPES
California Other P00758190 RAILROAD MEDICARE
California MEDICAID 00G722410 RAILROAD MEDICARE

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