Richard Owen Johnson, MD Valid NPI
Individual provider · Pediatrics Physician · Mammoth Lakes, CA
- NPI
- 1063528362
- Type
- Individual (Type 1)
- Primary specialty
- Pediatrics Physician (Pediatrics)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 208000000X
- License number
- G29540 (CA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-08-21
- Last updated
- 2013-04-16
Practice location
85 Sierra Park Road, Suite A
Mammoth Lakes, CA 93546
(760) 924-4000