Provider Demographics
NPI:1376634170
Name:BOCHNER, CLIFFORD JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:JEFFREY
Last Name:BOCHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8631 WEST THIRD STREET
Mailing Address - Street 2:SUITE 205E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-657-3601
Mailing Address - Fax:310-657-3838
Practice Address - Street 1:8631 WEST THIRD STREET
Practice Address - Street 2:SUITE 205E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-657-3601
Practice Address - Fax:310-657-3838
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43544174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist