Organization
NANCY J V BOHANNON, MD, MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY J BOHANNON MD (PRESIDENT)
(415) 648-7622
Entity
Organization
Contact information
Practice address
1580 VALENCIA ST, STE 504, SAN FRANCISCO, CA 94110-4423
(415) 648-7622
(415) 648-6805
Mailing address
1580 VALENCIA ST, STE 504, SAN FRANCISCO, CA 94110-4423
(415) 648-7622
(415) 648-6805
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A25795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A25795
STATE LICENSE
CA
Enumeration date
10/03/2011
Last updated
10/03/2011
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