Provider Demographics
NPI:1699943027
Name:JOHNSON, MEGAN CHRISTINE (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 PITCAIRN DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4702
Mailing Address - Country:US
Mailing Address - Phone:714-546-1593
Mailing Address - Fax:
Practice Address - Street 1:1855 PITCAIRN DR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4702
Practice Address - Country:US
Practice Address - Phone:714-546-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79052207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology