Kenneth Johan, MD
Internal Medicine in Victorville, CA. Individual provider (NPI-1).
NPI number1124690656
StatusActive
Last updated in NPPESSep 9, 2025
Details
- NPI
- 1124690656
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Johan
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 14, 2021
- Certification date
- Sep 9, 2025
- Last updated
- Sep 9, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | A195154 | CA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
16850 Bear Valley RdVictorville, CA 92395-5794
Phone 760-241-8000
Mailing address
16850 Bear Valley Rd Ste 203Victorville, CA 92395-5794
Phone 760-241-8000
Other practice locations
234 E 149th St Ste 8-20
Bronx, NY 10451-5504
Bronx, NY 10451-5504
Phone 718-579-5000
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