Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Larry Wayne Johnson, CO

Individual provider Specialist · NPI 1396983888

Mr. Larry Wayne Johnson, CO is a Specialist in San Diego, California. Licensed in California. Registered with an NPI since 2009.

Licensed in
CA
In the registry since
2009

Practice location Address checks out

9570 Ridgehaven Ct Ste C
San Diego, CA 92123-1667
Phone: (858) 278-0518
Fax: (858) 278-0323
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence CO2834 (CA)

Record details

NPI number1396983888
Entity typeIndividual (Type 1)
GenderMale
Credentials CO
Sole proprietorNo
NPI enumeratedJanuary 22, 2009
Last updated in NPPESJanuary 22, 2009

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