Active NPI
Grace U Bong
- Acupuncturist
- Ramona, CA
National Provider Identifier
1043039498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 20076
- Practice address
- 1516 Main St Ste 104
Ramona, CA 92065-5242 - Phone
- (760) 896-1333
- NPI assigned
- Oct 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 20076 | CA | Primary |
Addresses
Primary practice location
1516 Main St Ste 104
Ramona, CA 92065-5242
Mailing address
12740 Gateway Park Rd Apt 123
Poway, CA 92064-2076
Phone (858) 880-8139
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20076 | CA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1043039498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12740 GATEWAY PARK RD APT 123",
"city": "POWAY",
"state": "CA",
"postal_code": "920642076",
"telephone_number": "858-880-8139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 MAIN ST STE 104",
"city": "RAMONA",
"state": "CA",
"postal_code": "920655242",
"telephone_number": "760-896-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONG",
"first_name": "GRACE",
"middle_name": "U",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-03",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "20076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ramona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.