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1548332570
JACK W JOHNSON
GARDEN GROVE, CA
NPI
1548332570
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: CA G21314)
Enumeration Date
2006-11-14
Last Update Date
2007-07-08
Business Address
-- JACK W JOHNSON MD
12377 LEWIS STREET SUITE #104
GARDEN GROVE, CA 92840-4691
Phone number: 714-703-1366
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Mailing Address
-- JACK W JOHNSON MD
12377 LEWIS STREET SUITE #104
GARDEN GROVE, CA 92840-4691
Phone number: 714-703-1366
Copy
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