Diane L. Johnson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G62317 Issued in CA

Practice address

65 Pine Ave
#19
Long Beach, CA 90802-4718

Phone

(714) 402-4685

Fax

(562) 856-0389

NPI assigned

May 24, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ardent Healthcare, Inc.

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1841240157
  NPD (past)
• California Hospitalists Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Norwalk, CA
  • NPI 1760648539
  NPD (past)
• Emergency Department Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1730104498
  NPD (past)
• Intercare Medical Group, Inc.

  • Family Medicine Physician
  • Pleasanton, CA
  • NPI 1972821494
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1013962273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PINE AVE",
            "address_2": "#19",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024718",
            "telephone_number": "714-402-4685",
            "fax_number": "562-856-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PINE AVE",
            "address_2": "#19",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024718",
            "telephone_number": "714-402-4685",
            "fax_number": "562-856-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DIANE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G62317",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G62317",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G62317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOOD SAM RAILROAD",
            "identifier": "810000525",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "00G623170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G62317",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G623170",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G623170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coulsander Johnson
• Courtney Victoria Johnson, PMHNP
• Crystal Mae Johnson, PTA
• Daivana Johnson
• Deshawn Allen Johnson
• Dominique Johnson
• Donnice Nicole Johnson
• Eric Johnson
• Gerald L Johnson, MSD DMIN
• Geraldine Johnson, MSW

• Internal Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.