Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 34838 | CA |
NPI | 1003140096 |
---|---|
Provider Name | Dr. Sean Dennis Johnson |
First Address | Los Angeles, CA 90048-4107 |
Second Address | Los Angeles, CA 90048-4107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2009 |
Last Update Date | 24/09/2009 |