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General NPI Number Information
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NPI Number | 1689134348
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Entity Type | Individual
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Provider Name | NICHOLAS EDWARD BOHRER MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 655 EUCLID AVE STE 304
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2974
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Country | US
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Telephone | 619-267-8303
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Fax | 619-267-4835
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Provider Business Mailing Address
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Address Line | 5222 BALBOA AVE FL 5
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City | SAN DIEGO
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State | CA
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Zip | 92117-6904
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Country | US
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Telephone | 619-267-8303
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Fax | 619-267-4835
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | A182042
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4053
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License Number State | CA
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