Individual provider Active NPI

Lorraine Bonner, M.D.

  • Internal Medicine Physician
  • Alameda, CA
National Provider Identifier
1033188149
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G37622 Issued in CA
Practice address
2070 Clinton Ave
RM 2113
Alameda, CA 94501-4320
Phone
(510) 814-4397
Fax
(510) 814-4391
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G37622 CA Primary

Addresses

Primary practice location

2070 Clinton Ave
RM 2113
Alameda, CA 94501-4320

Mailing address

2070 Clinton Ave
Alameda, CA 94501-4399
Phone (510) 814-4397

Other identifiers 1

IdentifierTypeStateIssuer
00G376220MedicaidCA

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

LicenseStateTypeSpecialty
G37622CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Terry Past Accepting new patients
Alameda Inpatient Medical Inc Internal Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1033188149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 CLINTON AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014399",
            "telephone_number": "510-814-4397",
            "fax_number": "510-814-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 CLINTON AVE",
            "address_2": "RM 2113",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014320",
            "telephone_number": "510-814-4397",
            "fax_number": "510-814-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G37622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G376220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.