Elena Marie Bonk, RD
Individual provider Active NPI Registered Dietitian · Carson, CA
NPI 1144058413 · NPPES record last updated Jul 26, 2024
Key facts
- NPI
- 1144058413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2370 (SC)
- Practice address
- 20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506 - Phone
- (855) 442-5885
- NPI assigned
- Jul 26, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13041 | FL | MD | Registered Dietitian |
| 2370 | SC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vida Medical of Delaware PA | Dietitian, Registered | Current |
Accepting new patients |
Locations
20500 Belshaw Ave
#1377
Carson, CA 90746
Phone (415) 989-1017
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 13041 | FL | |
| Registered Dietitian | 133V00000X | 2370 | SC | Yes |
Addresses
Primary practice location
20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506
Mailing address
20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506
Phone (554) 425-8858
Other providers in Carson, CA
- Nancy Bobb
- Body Balance Holistics
- Parya Boghratian
- Linda R Bolland
- Bonfee Inc
- Nadia S Borchardt
- Bette Boyd
- Chynethia Boyd
- Sofie Elizabeth Boyer
- Annverda A Branson
All providers in Carson, CA · Registered Dietitian in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.