Individual
DR. DAVID BOHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
193 FAIRVIEW LN STE B, SONORA, CA 95370-4828
(209) 536-5100
(209) 588-0253
Mailing address
193 FAIRVIEW LN STE B, SONORA, CA 95370-4828
(209) 536-5100
(209) 588-0253
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20A16761
CA
Other
Enumeration date
05/13/2015
Last updated
08/20/2019
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