Active NPI
Paul W Johnson, M.D.
- Anesthesiology Physician
- Sacramento, CA
National Provider Identifier
1629064076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G68329
- Practice address
- 3315 Watt Ave
Sacramento, CA 95821-3600 - Phone
- (916) 481-6800
- Fax
- (916) 481-1881
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G68329 | CA | Primary |
Addresses
Primary practice location
3315 Watt Ave
Sacramento, CA 95821-3600
Mailing address
PO Box 660970
Sacramento, CA 95866-0970
Phone (916) 481-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| YYY20507Y | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G68329 | CA | MD | Anesthesiology Physician |
| 68329 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629064076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 660970",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958660970",
"telephone_number": "916-481-6800",
"fax_number": "916-481-1881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3315 WATT AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958213600",
"telephone_number": "916-481-6800",
"fax_number": "916-481-1881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "PAUL",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G68329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "YYY20507Y",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.