Provider Demographics
NPI:1780086298
Name:JOHNSON AND TASTO PARTNERSHIP
Entity type:Organization
Organization Name:JOHNSON AND TASTO PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:TASTO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-695-1776
Mailing Address - Street 1:9420 MIRA MESA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4848
Mailing Address - Country:US
Mailing Address - Phone:858-695-1776
Mailing Address - Fax:858-695-3769
Practice Address - Street 1:9420 MIRA MESA BLVD STE D
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4848
Practice Address - Country:US
Practice Address - Phone:858-695-1776
Practice Address - Fax:858-695-3769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41135122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty