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Individual
DR. ROBERT KEY BOLAN
Active
Individual
DR. ROBERT KEY BOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G39301
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G393010
—
CA
01
—
G39301
STATE LICENSE #
CA
Enumeration date
07/18/2005
Last updated
02/08/2018
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