Eunice N Bolivar MD, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A33374 Issued in CA

Legal business name

EUNICE N BOLIVAR MD, INC.

Practice address

598 N F St
San Bernardino, CA 92410-3110

Phone

(909) 882-6900

Fax

(909) 882-6110

NPI assigned

Feb 23, 2010

Organization subpart

No

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

Authorized official

Name

Bernadette F Costa

Title

Billing Manager

Phone

(909) 882-6900

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Eunice Bolivar, M.D.

  • Family Medicine Physician
  • San Bernardino, CA
  • NPI 1811929367
  NPD (past)

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1447572029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 N F ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103110",
            "telephone_number": "909-882-6900",
            "fax_number": "909-882-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 N F ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103110",
            "telephone_number": "909-882-6900",
            "fax_number": "909-882-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUNICE N BOLIVAR MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "909-882-6900"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A33374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.