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General NPI Number Information
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NPI Number | 1255207031
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Entity Type | Organization
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Legal Business Name | JE BOHM PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 5315 E TISBURY CT
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City | ANAHEIM
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State | CA
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Zip | 92807-4626
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Country | US
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Telephone | 714-476-2073
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Fax | 951-537-6931
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Provider Business Mailing Address
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Address Line | 14742 NEWPORT AVE STE 203
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City | TUSTIN
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State | CA
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Zip | 92780-6177
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Country | US
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Telephone | 714-476-2073
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Fax | 951-537-6931
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | JOHN BOHM
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Credential | MD
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Telephone | 714-476-2073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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