BLAIR R JOHNSON PA
NPI 1124082292
Physician Assistant - Medical in Covina, CA

Q: What is Blair Johnson's NPI number?

The NPI number for Blair Johnson is 1124082292. It was assigned to this individual provider in the NPPES registry on April 14, 2006.

Q: What is Blair Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Blair Johnson was last updated on October 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since April 14, 2006PECOS Enrolled

420 W ROWLAND ST, COVINA, CA 91723(626) 331-6411(626) 251-1560 Get Directions Write a Review

NPPES record last updated: October 14, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Blair R Johnson Pa NPPES

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

BLAIR R JOHNSON PA (NPI 1124082292) is an individual medical provider in Covina, California, licensed in California (PA11436) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124082292

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameBLAIR R JOHNSONCredential: PA

Location Address420 W ROWLAND STCovina, CA 91723-2943

Mailing Address420 W Rowland StCovina, CA 91723-2943 · (626) 331-6411 · Fax (626) 251-1560

Phone(626) 331-6411

Fax(626) 251-1560

Sole ProprietorNo

Enumeration DateApril 14, 2006

Last NPPES UpdateOctober 14, 2020

NPPES CertifiedOctober 14, 2020

✔ NPI 1124082292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA11436

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA11436 (CA)

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PA11436 (CA)

420 W ROWLAND ST, Covina, CA 91723

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blair R Johnson Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NEMISH S. PATEL M.D.

Internal Medicine