Thomas Dale Bohlmann, MD | |
1250 16th St, Santa Monica, CA 90404-1249 | |
(310) 319-4610 | |
(310) 576-6025 |
Full Name | Thomas Dale Bohlmann |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 1250 16th St, Santa Monica, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265448195 | NPI | - | NPPES |
00G617920 | Medicaid | CA | |
00G617920 | Other | CA | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | G61792 (California) | Primary |
Entity Name | Bayside Anesthesia Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184668469 PECOS PAC ID: 2466490560 Enrollment ID: O20050419001522 |
Mailing Address | Practice Location Address |
---|---|
Thomas Dale Bohlmann, MD P.o. Box 60790, Pasadena, CA 91116-6790 Ph: (626) 204-6747 | Thomas Dale Bohlmann, MD 1250 16th St, Santa Monica, CA 90404-1249 Ph: (310) 319-4610 |
Vivek Ram Vallurupalli, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 2121 Santa Monica Blvd, Santa Monica, CA 90404 Phone: 310-829-5511 | |
Dr. Daniel Sompoj Tongbai, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 1245 16th St Ste 225, Santa Monica, CA 90404 Phone: 310-319-2241 Fax: 310-319-2263 | |
Dr. Sophie M. Andriaschuk, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1328 22nd St, Santa Monica, CA 90404 Phone: 310-829-8202 | |
Daniel Cherkassky, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2121 Santa Monica Blvd, Santa Monica, CA 90404 Phone: 650-823-8969 | |
Dr. David Asher Rakoff, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1328 22nd St, Santa Monica, CA 90404 Phone: 310-423-2056 Fax: 310-423-8232 | |
Mark S. Goh, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 1328 22nd St, Santa Monica, CA 90404 Phone: 310-829-8202 Fax: 310-829-8209 | |
Dr. Kevin M. Miller, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1328 22nd St, St. John's Anesthesia Department, Santa Monica, CA 90404 Phone: 818-712-0598 Fax: 818-712-0598 |