| J.r. Johnson, M.d., Inc | |
|
901 Calle Amanecer Ste 100 San Clemente CA 92673 | |
| (949) 218-1470 | |
| (949) 218-1471 |
| Full Name | J.r. Johnson, M.d., Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 901 Calle Amanecer, San Clemente, California |
| Authorized Official Name and Position | James Robert Johnson (PRESIDENT) |
| Authorized Official Contact | 9492181470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J.r. Johnson, M.d., Inc 901 Calle Amanecer Ste 100 San Clemente CA 92673 Ph: (949) 218-1470 | J.r. Johnson, M.d., Inc 901 Calle Amanecer Ste 100 San Clemente CA 92673 Ph: (949) 218-1470 |
| NPI Number | 1184836066 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4385817360 |
|---|---|
| Medicare Enrollment ID | O20111108000474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184836066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | G69427 (California) | Primary |
| Provider Name | James Robert Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093864423 PECOS PAC ID: 5294908273 Enrollment ID: I20111108000504 |
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