Active NPI
Gabriel Magat Bonifacio, PT, DPT, CSCS
- Physical Therapist
- Huntington Beach, CA
National Provider Identifier
1427885847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 298681
- Practice address
- 7921 Professional Cir
Huntington Beach, CA 92648-1901 - Phone
- (714) 847-8751
- NPI assigned
- Sep 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 298681 | CA | Primary |
Addresses
Primary practice location
7921 Professional Cir
Huntington Beach, CA 92648-1901
Mailing address
13512 Evergreen St
Westminster, CA 92683-9309
Phone (714) 329-1750
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 298681 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1427885847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13512 EVERGREEN ST",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926839309",
"telephone_number": "714-329-1750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7921 PROFESSIONAL CIR",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926481901",
"telephone_number": "714-847-8751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONIFACIO",
"first_name": "GABRIEL",
"middle_name": "MAGAT",
"name_prefix": "Dr.",
"credential": "PT, DPT, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-18",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "298681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.