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General NPI Number Information
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NPI Number | 1972786382
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Entity Type | Individual
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Provider Name | OLGA LILIANA BOHN MD
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Gender | Female
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 4301 NORTHSTAR WAY
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City | MODESTO
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State | CA
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Zip | 95356-9262
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Country | US
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Telephone | 209-577-1200
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Fax | 209-577-6517
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Provider Business Mailing Address
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Address Line | 4301 NORTHSTAR WAY
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City | MODESTO
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State | CA
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Zip | 95356-9262
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Country | US
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Telephone | 209-577-1200
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Fax | 209-577-6517
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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 | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number | 57014204
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | P83459
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | P83459
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A142203
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License Number State | CA
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