Gary Andrew Johanson
Family Doctor Family Doctor - Hospice and Palliative Medicine
500 Doyle Park Dr Suite G04
Santa Rosa
, California 95405-4558
Gary Andrew Johanson
Family Doctor Family Doctor - Hospice and Palliative Medicine
500 Doyle Park Dr Suite G04
Santa Rosa
, California 95405-4558
(707) 573-0982
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About
Features
Specialties
- Family Doctor
- Family Doctor - Hospice and Palliative Medicine
Languages spoken
- English
Location
First Address
- Gary Andrew Johanson
- 500 Doyle Park Dr Suite G04
- Santa Rosa, CA
- Zip : 95405-4558
- Fax : (707) 573-0982
- Phone : (707) 573-8984
Second Address
- Gary Andrew Johanson
- 500 Doyle Park Dr Suite G04
- Santa Rosa, CA
- Zip : 95405-4558
- Fax : (707) 573-0982
- Phone : (707) 573-8984
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | G32438 | CA |
| Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | G32438 | CA |
National Provider Identifier
| NPI | 1215043229 |
|---|---|
| Provider Name | Gary Andrew Johanson |
| First Address | Santa Rosa, CA 95405-4558 |
| Second Address | Santa Rosa, CA 95405-4558 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/08/2006 |
| Last Update Date | 03/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 33-0185031 | TAX ID# AS OF 9/1/2010 (01) | CA |
| 680479679 | TAX ID (01) | CA |
| A45151 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.