Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC14648 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC14648 | CA |
NPI | 1710907886 |
---|---|
Provider Name | Dr. Robert Knight Johnston |
First Address | Fullerton, CA 92835-2301 |
Second Address | Fullerton, CA 92835-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |