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Dr. Gary Ronald Johnson, MD
General Practice Physician in San Andreas, California
NPI 1114013513

Gary Ronald Johnson is a General Practice Physician based in San Andreas, CA. Gary Ronald Johnson practices in San Andreas, CA and has the professional credentials of MD. The NPI Number for Gary Ronald Johnson is 1114013513 and holds a License No. G27755 (California).

The current practice location address for Gary Ronald Johnson is 588 W. St.charles Street, San Andreas, CA and can be reached out via phone at 209-754-1851 and via fax at 209-754-0231.

Location: 588 W. St.charles Street, San Andreas, CA, 95249
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114013513
Provider Name
Gary Ronald Johnson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
588 W. St.charles Street, San Andreas, CA, 95249
Phone Number
209-754-1851
Fax Number
209-754-0231
Provider Enumeration Date
10/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00G277550 05 CA
institution
Provider Business Practice Location Address Details
Address
588 W. St.charles Street
City
San Andreas
State
California
Zip
95249
Phone Number
209-754-1851
Fax Number
209-754-0231
person
Provider Business Mailing Address Details
Address
588 W. St.charles Street
City
San Andreas
State
California
Zip
95249
Phone Number
209-754-1851
Fax Number
209-754-0231
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
G27755 (California)
Definition
Definition to come...
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