Medical Doctors Group, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A30477 Issued in CA

Legal business name

MEDICAL DOCTORS GROUP, INC

Practice address

433 Estudillo Ave Ste 206
San Leandro, CA 94577-4915

Phone

(510) 969-4166

Fax

(510) 969-5530

NPI assigned

Jun 17, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ernest Lincoln Bonner Jr., M.D.NPI 1992785703

Title

Ceo

Phone

(510) 847-1581

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ernest Lincoln Bonner Jr., MD

  • Internal Medicine Physician
  • Alameda, CA
  • NPI 1992785703
  Medicare reassignment Authorized official
• Charles R Williams, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1760526743
  NPD (past)

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1407237159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 SANTA CLARA AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945012721",
            "telephone_number": "510-847-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 ESTUDILLO AVE STE 206",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774915",
            "telephone_number": "510-969-4166",
            "fax_number": "510-969-5530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10850 MacArthur Blvd",
            "address_2": "suite 303",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946055266",
            "country_code": "US",
            "telephone_number": "510-969-4166",
            "fax_number": "510-969-5530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL DOCTORS GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "LINCOLN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-847-1581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A30477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle McQueen, AMFT
• MDX-MDL Holdings, LLC
• Damien Kristopher Meadows, OTR/L
• Joan Catherine Medcalf, MSW
• Medical Arts Pharmacy LLC
• Medical Insights Diagnostic Centers Concord Professional Corporation
• Medichair Transportation LLC
• Isac Jobana Medina Reynoso
• Cynthia Medina
• Desiree Medina I

• Internal Medicine Physician in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.