Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 63448 | CA |
NPI | 1114211968 |
---|---|
Provider Name | Dr. Taoheed Olajide Johnson |
First Address | Chino Hills, CA 91709-4650 |
Second Address | Chino Hills, CA 91709-4650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2011 |
Last Update Date | 09/11/2016 |