Johnson, Jack W
Johnson, Jack W is an individual health care provider with primary practice located at 12377 Lewis Street Suite #104, Garden Grove CA 92840-4691. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Johnson, Jack W can be contacted via phone (714) 703-1366.Contact Information
Primary practice address
12377 Lewis Street Suite #104
Garden Grove CA 92840-4691
Phone: (714) 703-1366
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | G21314 | California |
Profile Details
| NPI number | 1548332570 |
|---|---|
| LBN Legal business name | Johnson, Jack W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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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