Individual provider Active NPI

Carl Bohn Jr.

  • Physical Therapy Assistant
  • Anaheim, CA
National Provider Identifier
1376934984
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT 3603 Issued in CA
Practice address
505 N Euclid St Ste 680
Anaheim, CA 92801-5509
Phone
(714) 780-0010
Fax
(714) 780-0050
NPI assigned
Feb 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT 3603 CA Primary

Addresses

Primary practice location

505 N Euclid St Ste 680
Anaheim, CA 92801-5509

Mailing address

505 N Euclid St Ste 680
Anaheim, CA 92801-5509
Phone (714) 780-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT 3603CAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1376934984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N EUCLID ST STE 680",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015509",
            "telephone_number": "714-780-0010",
            "fax_number": "714-780-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N EUCLID ST STE 680",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015509",
            "telephone_number": "714-780-0010",
            "fax_number": "714-780-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHN",
        "first_name": "CARL",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 3603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.