Active NPI
Samuel Bonderov
- Pastoral Counselor
- Whittier, CA
National Provider Identifier
1063169209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 8747 Nogal Ave
Whittier, CA 90606-2807 - Phone
- (562) 441-4903
- NPI assigned
- Mar 8, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | CA | Primary |
Addresses
Primary practice location
8747 Nogal Ave
Whittier, CA 90606-2807
Mailing address
8747 Nogal Ave
Whittier, CA 90606-2807
Phone (562) 441-4903
Other names 1
- Samuel Bonderov
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646697600000",
"number": "1063169209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8747 NOGAL AVE",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906062807",
"telephone_number": "562-441-4903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8747 NOGAL AVE",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906062807",
"telephone_number": "562-441-4903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONDEROV",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-08",
"last_updated": "2022-03-08",
"certification_date": "2022-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SAMUEL",
"last_name": "BONDEROV",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Whittier, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.