Provider Demographics
NPI:1891793600
Name:BOHMAN, HAROLD RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:RAY
Last Name:BOHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 555191
Mailing Address - Street 2:NAVAL HOSPITAL, DEPT OF SURGERY
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-5191
Mailing Address - Country:US
Mailing Address - Phone:760-725-1356
Mailing Address - Fax:760-725-0117
Practice Address - Street 1:NAVAL HOSPITAL
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-5191
Practice Address - Country:US
Practice Address - Phone:760-725-1356
Practice Address - Fax:760-725-0117
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG33753208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery