MICHAEL S BONGIOVANNI MD INC (NPI# 1497991988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497991988 |
| Entity Type | Organization |
| Organization Name | MICHAEL S BONGIOVANNI MD INC |
| Practice Address |
4060 4th Ave Suite 630 San Diego CA 92103-2116 |
| Practice Telephone | 6192993950 |
| Practice Fax Number | 6192993951 |
| Mailing Telephone | 6192993950 |
| Mailing Fax Number | 6192993951 |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2013-04-16 |
| Authorized Official Name | MICHAEL S BONGIOVANNI (PRESIDENT) |
| Authorized Official Telephone | 6192993950 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
G59386 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RR MEDICARE | 200042516 | 01 |
| CA | 00G593860 | 05 |
| Street Address |
4060 4TH AVE SUITE 630 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525299 | John Paul Molenaar | Audiologist | 4060 4th Ave, Ste 410a, San Diego, CA 92103-2121 | 2005-06-01 |
| 1598391740 | Sheena Lee Hays | Registered Nurse | 4060 4th Ave, San Diego, CA 92103-2116 | 2020-03-19 |
| 1336645324 | Kiyon Chung Md, Apc | Internal Medicine | 4060 4th Ave, Suite 650, San Diego, CA 92103-2121 | 2018-03-30 |
| 1003260894 | Erin Dwyer | Nurse Practitioner | 4060 4th Ave, Suite 310, San Diego, CA 92103-2116 | 2016-04-18 |
| 1336515642 | Leslie Monagle | Physical Therapist | 4060 4th Ave, Suite 206, San Diego, CA 92103-2116 | 2015-08-20 |
| 1598008583 | Stewart L. Frank Md, Inc. | Non-Pharmacy Dispensing Site | 4060 4th Ave, Suite 605, San Diego, CA 92103-2116 | 2013-03-28 |
| 1912269945 | Kennie Kwok | Dentist | 4060 4th Ave, Suite 303, San Diego, CA 92103-2116 | 2012-06-14 |
| 1124391974 | Central San Diego Surgery Center Inc. | Clinic/Center | 4060 4th Ave, Suite #120, San Diego, CA 92103-2116 | 2012-02-09 |
| 1366734220 | Joey Allen Clayton | Physician Assistant | 4060 4th Ave, Suite 700, San Diego, CA 92103-2116 | 2011-05-11 |
| 1578869772 | Jason R Hess Plastic Surgery Inc | Surgery | 4060 4th Ave, Suite 120, San Diego, CA 92103-2116 | 2011-02-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
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| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922495712 | Joseph Galal Elsissy | Orthopaedic Surgery | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2015-04-20 |
| 1104214238 | Lan N Nguyen Do PC | Orthopaedic Surgery | 3750 Convoy St, Suite 201, San Diego, CA 92111-3738 | 2014-12-23 |
| 1376778530 | Joel J. Smith, M.d. Inc. | Orthopaedic Surgery | 3750 Convoy Street, Suite 116, San Diego, CA 92111-3739 | 2009-05-18 |
| 1952543423 | Timothy Paul Craft | Orthopaedic Surgery | 5893 Copley Dr, Department of Orthopaedic Surgery, San Diego, CA 92111-7906 | 2009-03-30 |
| 1609924679 | Steven R. Schelkun | Orthopaedic Surgery | 4405 Vandever Ave, San Diego, CA 92120-3315 | 2007-01-08 |
| 1700898103 | Jeffrey M. Smith, M.d., Inc. | Orthopaedic Surgery | 3750 Convoy St, Suite 201, San Diego, CA 92111-3738 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835131 | Jacob Matz | Orthopaedic Surgery | Orthopaedic Trauma Institute, 2550 23rd St Building 9, 2nd Floor, San Francisco, CA 94110 | 2019-08-03 |
| 1609219658 | Matthew John Herring | Orthopaedic Surgery | Ucsf Orthopaedic Trauma Institute, 2550 23rd St., Bldg. 9, 2nd Floor, San Francisco, CA 94110 | 2013-04-09 |
| 1609038256 | Vahdatyar Amirpour M.d. Inc | Orthopaedic Surgery | 2501 H St, Bakersfield, CA 93301-2817 | 2008-06-25 |
| 1639336076 | Christian Seaholm Bromfield | Orthopaedic Surgery | 6600 Bruceville Rd Ste 111, Sacramento, CA 95823-4671 | 2008-05-22 |
| 1629255237 | David C Chang | Orthopaedic Surgery | 307 Placentia Ave., Suite # 111, Newport Beach, CA 92663 | 2008-01-25 |
| 1881881431 | Christopher Max Hoshino | Orthopaedic Surgery | 1000 W Carson St # 422, Torrance, CA 90502-2004 | 2007-09-27 |
| 1487840583 | John H. Serocki, Md, Apc | Orthopaedic Surgery | 9834 Genesee Ave #228, La Jolla, CA 92037 | 2007-09-21 |
| 1144300385 | Gary Jack Phipps | Orthopaedic Surgery | 26720 Crown Valley Parkway, Suite 200, Mission Viejo, CA 92691 | 2006-10-16 |
| 1013024926 | Aaron G. Osborne, D.o., Inc. | Orthopaedic Surgery | 2480 Sonoma St, Redding, CA 96001-3027 | 2006-08-24 |
| 1689689176 | Lorra Marie Sharp | Orthopaedic Surgery | 1955 Citracado Pkwy Ste 200, Escondido, CA 92029-4112 | 2006-07-31 |
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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.