Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95009541 | CA |
NPI | 1003307927 |
---|---|
Provider Name | Alan Johnstone |
First Address | San Francisco, CA 94111-3723 |
Second Address | San Francisco, CA 94111-3723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2018 |
Last Update Date | 12/03/2021 |