Provider Demographics
NPI:1265490387
Name:BOHMAN, WILLIAM R (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:BOHMAN
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 1:243 LAKEVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:EMERALD HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94062-3949
Mailing Address - Country:US
Mailing Address - Phone:650-208-9252
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-725-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65557207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G655570Medicaid
E82344Medicare UPIN
CA00G655571Medicare ID - Type Unspecified