Individual provider · Type 1 NPI

Johanna Back, MD

Student in an Organized Health Care Education/Training Program · Orange, CA

NPI number 1508626797 Active

Practice location

200 S Manchester Ave Ste 835
Orange, CA 92868-3213

Call (714) 480-2440 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XA210794 (CA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1508626797

Johanna Back, MD's National Provider Identifier is 1508626797, issued on Mar 22, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Orange, CA. The record was last updated on Aug 7, 2026.