| Noah Johnson MD PC | |
|
10158 Buena Vista Ave Santee CA 92071-4435 | |
| (619) 562-1140 | |
| (619) 562-5362 |
| Full Name | Noah Johnson MD PC |
|---|---|
| Speciality | Family Medicine |
| Location | 10158 Buena Vista Ave, Santee, California |
| Authorized Official Name and Position | Terri Woolley (OFFICE MANAGER) |
| Authorized Official Contact | 6195621140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Noah Johnson MD PC 10158 Buena Vista Ave Santee CA 92071-4435 Ph: (619) 562-1140 | Noah Johnson MD PC 10158 Buena Vista Ave Santee CA 92071-4435 Ph: (619) 562-1140 |
| NPI Number | 1811168388 |
|---|---|
| Provider Enumeration Date | 03/12/2008 |
| Last Update Date | 03/12/2008 |
| Medicare PECOS PAC ID | 7618964883 |
|---|---|
| Medicare Enrollment ID | O20040428001705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811168388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A79548 (California) | Primary |
| Provider Name | Noah C Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932215092 PECOS PAC ID: 8527055797 Enrollment ID: I20040430001242 |
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