Individual
ANTHONY BOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD JD
Contact information
Practice address
320 SUPERIOR AVE, #340, NEWPORT BEACH, CA 92663-2716
(949) 645-7172
(949) 642-7585
Mailing address
320 SUPERIOR AVE, #340, NEWPORT BEACH, CA 92663-2716
(949) 645-7172
(949) 642-7585
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
A23845
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000002688
MEDICARE EMC
CA
05
—
00A238450
—
CA
Enumeration date
08/10/2005
Last updated
09/10/2013
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