Provider Demographics
NPI:1710907886
Name:JOHNSTON, ROBERT KNIGHT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KNIGHT
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3249 ASSOCIATED RD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2301
Mailing Address - Country:US
Mailing Address - Phone:714-529-0840
Mailing Address - Fax:714-529-0840
Practice Address - Street 1:3249 ASSOCIATED RD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2301
Practice Address - Country:US
Practice Address - Phone:714-529-0840
Practice Address - Fax:714-529-0840
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14648111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT17847Medicare ID - Type Unspecified