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DR. ROBERT KEY BOLAN M.D. NPI 1386643831


NPI Information

NPI: 1386643831
Provider Name: DR. ROBERT KEY BOLAN, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1625 SCHRADER BLVD
3RD FLOOR
LOS ANGELES, CA
ZIP 90028
Phone: (323) 993-7500
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DR. Robert Key Bolan, M.D. is a specialist in Los Angeles, CA with 52 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Robert Key Bolan, M.D. NPI is 1386643831. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduation Year:1972

The provider's business location address is:

1625 SCHRADER BLVD
3RD FLOOR
LOS ANGELES, CA
ZIP 90028-213
Phone: (323) 993-7500
Fax: (323) 308-4015

The NPI 1386643831 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/18/2005 and was last updated on 2/8/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG39301CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G393010MEDICAIDCALIFORNIA
2G39301OTHERCALIFORNIASTATE LICENSE #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.