Jeffrey M. Johnsrud, a Medical Corporation

NPI #1215238522 in Orange, California

Provider Information

NPI Number: 1215238522
Entity Type: Organization
Organization Name: Jeffrey M. Johnsrud, a Medical Corporation
Primary Specialty: Specialist
Enumeration Date: Nov 3, 2010
Last Updated: Mar 31, 2011

Practice Location

Address: 1140 W LA VETA AVE
Address 2: SUITE 760
City: Orange
State: California
ZIP Code: 92868-4223
Phone: (714) 541-4442

Authorized Official

Name: PATRICIA FUENTES
Title: CREDENTIALING
Phone: (714) 619-5450

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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