Provider Demographics
NPI:1275777823
Name:JOHNSON FIRST CARE INC
Entity type:Organization
Organization Name:JOHNSON FIRST CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-290-4662
Mailing Address - Street 1:1234 FRUSSEL
Mailing Address - Street 2:#278
Mailing Address - City:LOS ANGLES
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3577
Mailing Address - Country:US
Mailing Address - Phone:302-290-4662
Mailing Address - Fax:
Practice Address - Street 1:1234 FRUSSEL
Practice Address - Street 2:#278
Practice Address - City:LOS ANGLES
Practice Address - State:CA
Practice Address - Zip Code:90211-3577
Practice Address - Country:US
Practice Address - Phone:302-290-4662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41528207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Single Specialty