BONNIE WONG (NPI# 1437404415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437404415 |
| Entity Type | Individual |
| Full Name | BONNIE WONG |
| Credential | DO |
| Practice Address |
902 Lakeview Ave Southern Colorado Family Medicine Pueblo CO 81004-3798 |
| Mailing Address |
2116 Wyoming Ave Pueblo CO 81004-3752 |
| Practice Telephone | 7195575872 |
| Mailing Telephone | 2069993950 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | TL-4526 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | COLORADO TRAINING LICENSE NUMBER | TL-4526 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033523717 | Bonnie Wong | Psychiatry & Neurology | 451 Clarkson Ave Rm B5110, Brooklyn, NY 11203-2097 | 2014-06-20 |
| 1215964853 | Bonnie Wong | Clinical Neuropsychologist | Bidmc/behavioral Neurology Unit, 2nd Fl, 330 Brookline Avenue, Boston, MA 02215 | 2006-06-27 |
| 1184100257 | Bonnie Wong | Social Worker | 100 George P Hassett Dr, Medford, MA 02155-3258 | 2018-07-12 |
| 1891157830 | Bonnie Michelle Wong | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2016-03-28 |
| 1801908876 | Bonnie X Wong | Pharmacist | 5901 E 7th St, Long Beach, CA 90822-5201 | 2006-08-31 |
| Street Address |
902 LAKEVIEW AVE SOUTHERN COLORADO FAMILY MEDICINE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-3798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376549840 | Laura A Stein | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004 | 2005-06-21 |
| 1972114676 | Catholic Health Initiatives Colorado | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-08-14 |
| 1275154668 | Alexander Thomas Grover | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-27 |
| 1336769843 | Sydney Marie Brock | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-24 |
| 1225658172 | Ashima Singh | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-21 |
| 1467072249 | Joel Scott Bonzo | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-21 |
| 1023638053 | Patrick Henke | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-20 |
| 1659991917 | Kelsi Rae Brown | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-16 |
| 1205474210 | John De Villa | Nurse Practitioner | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2019-12-20 |
| 1033773627 | Queenter Kisang | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2019-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356992606 | Kristie Lamotta | Family Medicine | 1600 N Grand Ave Ste 350, Pueblo, CO 81003-2729 | 2019-09-26 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1134484660 | Aparna Seetharama | Family Medicine | 1600 N. Grand Ave, Ste 260, Pueblo, CO 81003-2729 | 2012-07-11 |
| 1710275037 | Catholic Health Initiatives Colorado | Family Medicine | 916 Indiana Ave., Suite 120, Pueblo, CO 81004 | 2011-07-20 |
| 1124336169 | Timothy J Cawlfield, Md, Pllc | Family Medicine | 41 Montebello Rd Ste 210, Pueblo, CO 81001-1379 | 2010-09-23 |
| 1639308828 | Emma Iovane Stout | Family Medicine | 115 E. Riverwalk, Suite 200, Pueblo, CO 81003-2246 | 2009-07-08 |
| 1750510145 | Wendy Alejandra Girard | Family Medicine | 1925 East Orman Avenue, Suite A109, Pueblo, CO 81004 | 2009-07-07 |
| 1881839694 | Bryan A Hynes | Family Medicine | 415 N Grand Ave, Pueblo, CO 81003-3111 | 2008-12-08 |
| 1093988917 | Louise Mcdade | Family Medicine | 8 Carlile Pl, Pueblo, CO 81004-1213 | 2008-04-11 |
| 1891914693 | Prairie Medical Clinic Pllc | Family Medicine | 1726 S Prairie Ave, Pueblo, CO 81005-2253 | 2007-04-24 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.