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General NPI Number Information
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NPI Number | 1417220138
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Entity Type | Organization
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Legal Business Name | MICHAEL SCOTT BOHLMAN MD INC
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 1100 E ALMOND AVE SUITE 101
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City | MADERA
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State | CA
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Zip | 93637-5692
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Country | US
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Telephone | 559-675-1231
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Fax |
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Provider Business Mailing Address
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Address Line | 22249 STABULIS CT
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City | MADERA
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State | CA
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Zip | 93638-7813
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Country | US
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Telephone | 559-662-0950
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL BOHLMAN
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Credential | MD
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Telephone | 559-417-7743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A94481
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A94482
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License Number State | CA
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