Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | G47238 | CA |
NPI | 1255623245 |
---|---|
Provider Name | Dr. Ramona Elizabeth Johnson |
First Address | Irvine, CA 92604-0315 |
Second Address | Irvine, CA 92604-0315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2011 |
Last Update Date | 09/05/2011 |