Active NPI
Pamela Susan Bohrer, MD
- Otolaryngology Physician
- Walnut Creek, CA
National Provider Identifier
1497839476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- G69280
- Practice address
- 106 La Casa Via Ste 100
Walnut Creek, CA 94598-3084 - Phone
- (925) 239-2900
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | G69280 | CA | Primary |
Addresses
Primary practice location
106 La Casa Via Ste 100
Walnut Creek, CA 94598-3084
Mailing address
106 La Casa Via Ste 100
Walnut Creek, CA 94598-3084
Phone (925) 239-2900
Other practice location 1
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone (707) 571-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G692800 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69280 | CA | MD | Pharmacist |
| G69280 | CA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717977600000",
"number": "1497839476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LA CASA VIA STE 100",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945983084",
"telephone_number": "925-239-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LA CASA VIA STE 100",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945983084",
"telephone_number": "925-239-2900"
}
],
"practiceLocations": [
{
"address_1": "401 Bicentennial Way",
"address_purpose": "LOCATION",
"city": "Santa Rosa",
"state": "CA",
"postal_code": "954032149",
"country_code": "US",
"telephone_number": "707-571-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOHRER",
"first_name": "PAMELA",
"middle_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2024-06-10",
"certification_date": "2024-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "G69280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G692800",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "401 Bicentennial Way",
"city": "Santa Rosa",
"state": "CA",
"country_code": "US",
"postal_code": "954032149",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.