Individual provider Active NPI

Eric O. Johnson, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1346334935
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G55858 Issued in CA
Practice address
7565 Mission Valley Rd
Suite 200
San Diego, CA 92108-4431
Phone
(619) 245-2830
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G55858 CA Primary

Addresses

Primary practice location

7565 Mission Valley Rd
Suite 200
San Diego, CA 92108-4431

Mailing address

File# 54433
Los Angeles, CA 90074

Other identifiers 1

IdentifierTypeStateIssuer
00G558580MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080707000737 CA Practitioner - Internal Medicine 2961574082 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55858CAMDDentist
G55858CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
Scripps Health CurrentSince Jun 1, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Internal Medicine Current Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10170 Sorrento Valley Rd
#5
San Diego, CA 92121
Phone (858) 754-5767

9730 Summers Ridge Rd
#100
San Diego, CA 92121
Phone (858) 549-7400

Interoperability endpoints

  • Direct secure messaging: ejohnson9834@scrippshlth.medalliesdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1346334935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE# 54433",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7565 MISSION VALLEY RD",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084431",
            "telephone_number": "619-245-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIC",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G55858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G558580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.