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1396983888
LARRY WAYNE JOHNSON
SAN DIEGO, CA
NPI
1396983888
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: CA CO2834)
Enumeration Date
2009-01-22
Last Update Date
2009-01-22
Business Address
Mr. LARRY WAYNE JOHNSON C.O.
9570 RIDGEHAVEN CT SUITE C
SAN DIEGO, CA 92123-1667
Phone number: 858-278-0518
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Mailing Address
Mr. LARRY WAYNE JOHNSON C.O.
10723 MONTEGO DR
SAN DIEGO, CA 92124-1910
Phone number: 858-565-2230
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