Richard G Johnson Jr., M.D

Primary specialty

SpecialistTaxonomy code 174400000X

License

G45973 Issued in CA

Practice address

415 W Carroll Ave
Glendora, CA 91741-4208

Phone

(626) 914-5219

Fax

(626) 914-7846

NPI assigned

Dec 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Confermed of California PC

  • Internal Medicine Physician
  • Irvine, CA
  • NPI 1316584709
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Richard G Johnson MD Inc

  • Specialist
  • Glendora, CA
  • NPI 1689694523
  Authorized official Same address or phone
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Confermed PC

  • Internal Medicine Physician
  • Middletown, CT
  • NPI 1376190850
  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1083691182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W CARROLL AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414208",
            "telephone_number": "626-914-5219",
            "fax_number": "626-914-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W CARROLL AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414208",
            "telephone_number": "626-914-5219",
            "fax_number": "626-914-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RICHARD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G45973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G459730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John W. Conrad D.C. Corp.
• John W. Ritter MD Inc.
• John W. Tam Podiatry Corp
• Benjamin Dean Johnson, D.C.
• Charles Johnson
• Joints Chiropractic LLC
• Raymond Alfred Jones, LMFT
• Virginia Alvarado Jones, MD
• Jose C Briones, Jr. M.D., Inc.
• Jose Manuel Zozaya MD a Professional Corp

• Specialist in Glendora, CA
• Providers in Glendora, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.