Individual provider Active NPI

Teresa Rozon Bondoc, MD

  • Pediatrics Physician
  • Long Beach, CA
National Provider Identifier
1245224831
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A49027 Issued in CA
Practice address
2700 N Bellflower Blvd
Suite # 115
Long Beach, CA 90815-1129
Phone
(562) 425-1275
Fax
(562) 982-0173
NPI assigned
Sep 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A49027 CA Primary

Addresses

Primary practice location

2700 N Bellflower Blvd
Suite # 115
Long Beach, CA 90815-1129

Mailing address

2700 N Bellflower Blvd
Suite # 115
Long Beach, CA 90815-1129
Phone (562) 425-1275

Other identifiers 1

IdentifierTypeStateIssuer
00A490270MedicaidCA

Other names 1

  • Dr. Teresa Viterbo Rozon-Bondoc Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A49027CAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1245224831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N BELLFLOWER BLVD",
            "address_2": "SUITE # 115",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151129",
            "telephone_number": "562-425-1275",
            "fax_number": "562-982-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N BELLFLOWER BLVD",
            "address_2": "SUITE # 115",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151129",
            "telephone_number": "562-425-1275",
            "fax_number": "562-982-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDOC",
        "first_name": "TERESA",
        "middle_name": "ROZON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A49027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A490270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "ROZON-BONDOC",
            "middle_name": "VITERBO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.