| W Irving Johnson MD Inc | |
|
418 30th Street Oakland CA 94609-3302 | |
| (510) 208-5100 | |
| (510) 465-6810 |
| Full Name | W Irving Johnson MD Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 418 30th Street, Oakland, California |
| Authorized Official Name and Position | William Irving Johnson (CORP PRESIDENT PHYSICIAN) |
| Authorized Official Contact | 5102085100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| W Irving Johnson MD Inc 418 30th Street Oakland CA 94609-3302 Ph: (510) 208-5100 | W Irving Johnson MD Inc 418 30th Street Oakland CA 94609-3302 Ph: (510) 208-5100 |
| NPI Number | 1093799942 |
|---|---|
| Provider Enumeration Date | 12/05/2005 |
| Last Update Date | 12/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093799942 | NPI | - | NPPES |
| 00C360880 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | C36088 (California) | Primary |
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