Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | A40003 | CA |
NPI | 1073775441 |
---|---|
Provider Name | Dr. Lindsay Mitchell Johnson |
First Address | Santa Cruz, CA 95062 |
Second Address | Santa Cruz, CA 95062-2129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2008 |
Last Update Date | 27/06/2008 |