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General NPI Number Information
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NPI Number | 1033843040
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Entity Type | Organization
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Legal Business Name | JOHN BOHM MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 11700 ARTESIA BLVD
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City | ARTESIA
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State | CA
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Zip | 90701-3804
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Country | US
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Telephone | 714-944-6666
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Fax |
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Provider Business Mailing Address
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Address Line | 5267 WARNER AVE # 341
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-4079
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Country | US
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Telephone | 310-993-6912
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN BOHM
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Credential | MD
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Telephone | 310-993-6912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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