Provider Demographics
NPI:1750422358
Name:JOHNSON, CHRISTOPHER DOUGLAS (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DOUGLAS
Last Name:JOHNSON
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 1:295 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-1020
Mailing Address - Country:US
Mailing Address - Phone:714-770-8300
Mailing Address - Fax:714-770-8311
Practice Address - Street 1:13710 WHITTIER BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-4412
Practice Address - Country:US
Practice Address - Phone:562-945-1310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor