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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