1811180318 NPI number — ROBERT R JOHNSON MEDICAL CORP

Table of content: (NPI 1811180318)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811180318 NPI number — ROBERT R JOHNSON MEDICAL CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT R JOHNSON MEDICAL CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JOHNSON & JOHNSON PSYCHIATRIC CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811180318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3151 AIRWAY AVE
Provider Second Line Business Mailing Address:
SUITE T2
Provider Business Mailing Address City Name:
COSTA MESA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92626
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-556-2112
Provider Business Mailing Address Fax Number:
714-556-0120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3151 AIRWAY AVE
Provider Second Line Business Practice Location Address:
SUITE T2
Provider Business Practice Location Address City Name:
COSTA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-556-2112
Provider Business Practice Location Address Fax Number:
714-556-0120
Provider Enumeration Date:
08/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-556-2112

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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