Frank Anthony Bonavita, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G52398 Issued in CA

Practice address

2240 N Harbor Blvd
Ste 200
Fullerton, CA 92835-2635

Phone

(714) 870-4665

Fax

(714) 870-1582

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Caduceus Physicians Medical Group

  • Family Medicine Physician
  • Yorba Linda, CA
  • NPI 1497702724
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1366446312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 N HARBOR BLVD",
            "address_2": "STE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352635",
            "telephone_number": "714-870-4665",
            "fax_number": "714-870-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 N HARBOR BLVD",
            "address_2": "STE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352635",
            "telephone_number": "714-870-4665",
            "fax_number": "714-870-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAVITA",
        "first_name": "FRANK",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G52398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Charles Bollin Jr., MD
• Bom Jeon Dental Corp
• Bom Seok Jeon, DDS, Inc
• Bom Vichae Home Health Agency LLC
• Bom Vichae Physical Therapy Professional Corporation
• David Michael Boner
• Genille Marie Bonilla-Taylor
• Maria Elena Bonilla
• Sarina Bontty
• Rachel Morgan Boone

• Cardiovascular Disease Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.