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GARY R JOHNSON MD, INC
NPI 1073695557
Legal Medicine in San Andreas, CA

Active since October 20, 2006CLIA 05D0862377 · Microscopy
588 W ST CHARLES, SAN ANDREAS, CA 95249(209) 754-1851(209) 754-0231 Get Directions Write a Review

NPPES record last updated: July 10, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gary R Johnson Md, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY R JOHNSON MD, INC (NPI 1073695557) is a healthcare organization registered as a legal medicine in San Andreas, California and active in the NPI registry since October 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Gary Ronald Johnson, Owner/physican, as its authorized official.

NPPES Registry Identity

NPI1073695557
Entity TypeOrganization
Primary Taxonomy173000000X
Legal Business NameGARY R JOHNSON MD, INC
Location Address588 W ST CHARLESSan Andreas, CA 95249
Mailing AddressPo Box 580San Andreas, CA 95249-0580 · (209) 754-1851 · Fax (209) 754-0231
Phone(209) 754-1851
Fax(209) 754-0231
Organization SubpartNo
Authorized OfficialGary Ronald JohnsonOwner/physican · (209) 754-1851
Enumeration DateOctober 20, 2006
Last NPPES UpdateJuly 10, 2019
✔ NPI 1073695557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLegal MedicineOther Service Providers
Taxonomy Code173000000X
License✔ Licensed in CA · G27755
Definition
The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
588 W ST CHARLES, San Andreas, CA 95249
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Other Identifiers 2

Other1114013513CA · Individual Npi
Medicaid00G277550CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0862377

Gary R Johnson MD · San Andreas, CA
Active · expires Aug 31, 2026
CLIA Number05D0862377
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorGary R. Johnson MD
Laboratory Phone(209) 754-1851
Laboratory LocationGary R Johnson MD588 W St Charles St, San Andreas, CA 95249
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary R Johnson MD, Inc's NPI number?

The NPI number for Gary R Johnson MD, Inc is 1073695557. It was assigned to this organization in the NPPES registry on October 20, 2006.

Where is Gary R Johnson MD, Inc located?

Gary R Johnson MD, Inc is located at 588 W St Charles, San Andreas, CA 95249. The listed phone number is (209) 754-1851.

What is Gary R Johnson MD, Inc's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Does Gary R Johnson MD, Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0862377) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gary R Johnson MD, Inc was last updated on July 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.