Johnson, Kenneth Burton

Johnson, Kenneth Burton is an individual health care provider with primary practice located at 769 Medical Center Ct Suite 202, Chula Vista CA 91911-6660. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Johnson, Kenneth Burton can be contacted via phone (619) 482-8430.

Contact Information

Primary practice address
769 Medical Center Ct Suite 202 Chula Vista CA 91911-6660
Phone: (619) 482-8430
Fax: (619) 482-8005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X A79802 California

Profile Details

NPI number 1063527711
LBN Legal business name Johnson, Kenneth Burton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2006
Last updated Jul 19th, 2012 - about 14 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 1063527711 NPPES
California MEDICAID GR0100450

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