Noah Johnson Md Pc | |
10158 Buena Vista Ave Santee CA 92071-4435 | |
(619) 562-1140 | |
(619) 562-5362 |
Full Name | Noah Johnson Md Pc |
---|---|
Speciality | Family Medicine |
Location | 10158 Buena Vista Ave, Santee, California |
Authorized Official Name and Position | Terri Woolley (OFFICE MANAGER) |
Authorized Official Contact | 6195621140 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Noah Johnson Md Pc 10158 Buena Vista Ave Santee CA 92071-4435 Ph: (619) 562-1140 | Noah Johnson Md Pc 10158 Buena Vista Ave Santee CA 92071-4435 Ph: (619) 562-1140 |
NPI Number | 1811168388 |
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Provider Enumeration Date | 03/12/2008 |
Last Update Date | 03/12/2008 |
Medicare PECOS PAC ID | 7618964883 |
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Medicare Enrollment ID | O20040428001705 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811168388 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A79548 (California) | Primary |
Provider Name | Noah C Johnson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932215092 PECOS PAC ID: 8527055797 Enrollment ID: I20040430001242 |
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