Provider Demographics
NPI:1346361110
Name:VON POHL, JOACHIM WOLFGANG (MD)
Entity Type:Individual
Prefix:DR
First Name:JOACHIM
Middle Name:WOLFGANG
Last Name:VON POHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1915 JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-2712
Mailing Address - Country:US
Mailing Address - Phone:925-376-3040
Mailing Address - Fax:925-631-0583
Practice Address - Street 1:1915 JOSEPH DR
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-2712
Practice Address - Country:US
Practice Address - Phone:925-376-3040
Practice Address - Fax:925-631-0583
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38419207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF15366Medicare UPIN