MR. LARRY WAYNE JOHNSON C.O. NPI 1396983888

NPI Information

MR. Larry Wayne Johnson, C.O. is a specialist in San Diego, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MR. Larry Wayne Johnson, C.O. NPI is 1396983888. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9570 RIDGEHAVEN CT
SUITE C
SAN DIEGO, CA
ZIP 92123-667
Phone: (858) 278-0518
Fax: (858) 278-0323

The enumeration date for this NPI number is 1/22/2009 and was last updated on 1/22/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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