Provider Demographics
NPI:1275578957
Name:MOHRBACHER, ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:MOHRBACHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-1309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5100
Mailing Address - Fax:323-442-5641
Practice Address - Street 1:1441 EASTLAKE AVE
Practice Address - Street 2:NOR 8302E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0112
Practice Address - Country:US
Practice Address - Phone:323-442-5100
Practice Address - Fax:323-442-5641
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76827207RH0000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902846306OtherGROUP NPI
CAW18762OtherMEDICARE GROUP ID
CA00G768270OtherBLUE SHIELD
CA110083648OtherRAILROAD MEDICARE
CACE1617OtherGROUP RAILROAD MEDICARE
CA00G768270Medicaid
CAGR0016910OtherGROUP MEDICAID PIN
CAGR0016910OtherGROUP MEDICAID PIN
CA1902846306OtherGROUP NPI