Mildrede N Bonglack, MD

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

A204492 Issued in CA

Practice address

2210 E Illinois Ave Ste 408
Fresno, CA 93701-2184

Phone

(559) 443-2694

Fax

(559) 443-2696

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Obstetrics/Gynecology

Education

University of Cincinnati College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central California Faculty Medical Group IncGroup PAC ID 8325952773, 256 clinicians

Golden Valley Health CentersGroup PAC ID 4183527187, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Regional Medical Center Hospital, Fresno, CA, CCN 050060

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 27)

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.

• Central California Faculty Medical Group, Inc.

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1457603573
  Medicare reassignment Care Compare group NPD
• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment Care Compare group NPD
• Trihealth H LLC

  • Obstetrics Physician
  • Cincinnati, OH
  • NPI 1811215742
  Medicare reassignment NPD
• Central California Faculty Medical Group, Inc.

  • Internal Medicine Physician
  • Clovis, CA
  • NPI 1992742852

  Obstetrics & Gynecology

  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1518298306
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)
• United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Huron, CA
  • NPI 1134101686
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  Care Compare affiliation

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1134612013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-453-5200",
            "fax_number": "559-453-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 E ILLINOIS AVE STE 408",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012184",
            "telephone_number": "559-443-2694",
            "fax_number": "559-443-2696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "797 W Childs Ave",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953416805",
            "country_code": "US",
            "telephone_number": "209-384-6498",
            "fax_number": "209-359-2045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONGLACK",
        "first_name": "MILDREDE",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CA",
            "license": "A204492",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A204492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bond Medical Clinic Inc
• Niyati Bondale
• Bone Density Medical Group of Fresno, Inc.
• Ayako Bonesteel, NP-C
• David Ward Bonesteel
• Reed Bonham, RPH
• Brianna Boni
• Burke J. Bonilla, M.D.
• Celestina L. Bonilla, MS
• Claudia I Bonilla

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.