NPI 1609102698

Trevor Russell Johnson, OTC

Practitioner Surgical Assistant Encinitas, CA

Practice location

Address: 320 Santa Fe Dr STE 301, Encinitas, CA 92024-5140
Phone: (760) 633-4700
Fax: (760) 635-4344
Mailing address: 6619 Bell Bluff Ave, San Diego, CA 92119-1148

Registered specialties

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X Licence OTC 09-0802

Other Specialist/Technologist, Other providers in California →

Registry record

NPI: 1609102698
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Oct 2009
Record last updated: 26 Oct 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.