Provider Demographics
NPI:1598778128
Name:ROBERT S JOHNSON MD INC
Entity Type:Organization
Organization Name:ROBERT S JOHNSON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STURGEON
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-342-5184
Mailing Address - Street 1:1517 MANCHESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2434
Mailing Address - Country:US
Mailing Address - Phone:530-342-5184
Mailing Address - Fax:530-342-6462
Practice Address - Street 1:1517 MANCHESTER ROAD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2434
Practice Address - Country:US
Practice Address - Phone:530-342-5184
Practice Address - Fax:530-342-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA16031208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty