Provider Demographics
NPI:1982785853
Name:JOHNSTON, WILLIAM ROCH (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROCH
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:18124 CULVER DR
Mailing Address - Street 2:STE G UNIVERSITY PARK CHIROPRACTIC
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2729
Mailing Address - Country:US
Mailing Address - Phone:949-786-8802
Mailing Address - Fax:949-786-8875
Practice Address - Street 1:18124 CULVER DRIVE
Practice Address - Street 2:SUITE G UNIVERSITY PARK CHIROPRACTIC
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2729
Practice Address - Country:US
Practice Address - Phone:949-786-8802
Practice Address - Fax:949-786-8875
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC21727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC21727Medicare ID - Type Unspecified