MEDICARE: JOHN E BOHM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	A051741	CA

General Provider Information

NPI Number	:	1992771604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN E BOHM M.D.

Provider Business Mailing Address
First Line	:	5267 WARNER AVE # 341
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4079
Country	:	US
Telephone Number	:	310-993-6912
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 W COLE BLVD STE B
Second Line	:
City	:	CALEXICO
State	:	CA
Zip	:	92231-9700
Country	:	US
Telephone Number	:	760-890-0190
Fax Number	:	760-890-0160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	10/24/2023

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Directions to “ JOHN E BOHM M.D.” Practice Location

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