Individual provider Active NPI

Laurie Louise Johnston, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1457360240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G062814 Issued in CA
Practice address
3914 Murphy Canyon Rd
Suite A150
San Diego, CA 92123-4491
Phone
(858) 573-9902
Fax
(858) 573-9906
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 G062814 CA Primary

Addresses

Primary practice location

3914 Murphy Canyon Rd
Suite A150
San Diego, CA 92123-4491

Mailing address

17188 Libertad Dr
San Diego, CA 92127-1331
Phone (858) 673-0356

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
I20190711002184 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9830110709

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G062814CAMDInternal Medicine Physician
62814CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457360240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17188 LIBERTAD DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271331",
            "telephone_number": "858-673-0356",
            "fax_number": "858-673-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 MURPHY CANYON RD",
            "address_2": "SUITE A150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234491",
            "telephone_number": "858-573-9902",
            "fax_number": "858-573-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "LAURIE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G062814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.