Organization Active NPI

California Occupational Medicine Practice Inc

  • General Practice Physician
  • Selma, CA
National Provider Identifier
1306988746
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A79547 Issued in CA
Legal business name
CALIFORNIA OCCUPATIONAL MEDICINE PRACTICE INC
Practice address
1142 Rose Avenue
Selma, CA 93662
Phone
(559) 891-8940
NPI assigned
Feb 13, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Marc Douglass Johnson, MDNPI 1033251681
Title
Ceo
Phone
(831) 901-6856

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Preventive Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2083S0010X A79547 CA
Occupational Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2083X0100X A79547 CA
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X A79547 CA Primary

Addresses

Primary practice location

1142 Rose Avenue
Selma, CA 93662

Mailing address

PO Box 52060
Pacific Grove, CA 93950
Phone (831) 901-6856

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1306988746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52060",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "93950",
            "telephone_number": "831-901-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 ROSE AVENUE",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "93662",
            "telephone_number": "559-891-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA OCCUPATIONAL MEDICINE PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "DOUGLASS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-901-6856",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "CA",
            "license": "A79547",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "A79547",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A79547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.