Michael S Bongiovanni MD Inc

Primary specialty

Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X

License

G59386 Issued in CA

Legal business name

MICHAEL S BONGIOVANNI MD INC

Practice address

4060 4TH Ave
Suite 630
San Diego, CA 92103-2116

Phone

(619) 299-3950

Fax

(619) 299-3951

NPI assigned

Jan 5, 2009

Last updated

Apr 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael S Bongiovanni, M.D.NPI 1992772784

Title

President

Phone

(619) 299-3950

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael S Bongiovanni, M.D.

  • Orthopaedic Surgery Physician
  • San Diego, CA
  • NPI 1992772784
  Authorized official Same address or phone

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1497991988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE",
            "address_2": "SUITE 630",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "619-299-3950",
            "fax_number": "619-299-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE",
            "address_2": "SUITE 630",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "619-299-3950",
            "fax_number": "619-299-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL S BONGIOVANNI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "BONGIOVANNI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-299-3950",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "CA",
            "license": "G59386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200042516",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G593860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael Ratter, M.D., a Professional Corporation
• Michael S Duffy Sr DO Inc (Pacific Medical Care)
• Michael S Singer DDS Inc (Bernardo Center Dentistry)
• Michael Song MD a Professional Medical Corporation
• Michael T Couris MD Inc
• Michael T Lardon MD Apc

• Orthopaedic Trauma Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthopaedic Trauma Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.