David C Bonovich MD

Primary specialty

Vascular Neurology PhysicianTaxonomy code 2084V0102X

License

G71726 Issued in CA

Legal business name

DAVID C BONOVICH MD

Practice address

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305

Phone

(503) 579-5000

Fax

(503) 579-5001

NPI assigned

Jan 13, 2018

Organization subpart

No

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

Authorized official

Name

Leane Wadsworth

Title

Office Manager

Phone

(503) 579-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• David C. Bonovich, M.D.

  • Neurology Physician
  • San Francisco, CA
  • NPI 1518078443
  Medicare reassignment NPD

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

{
    "created_epoch": "1515801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1508374489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14780 SW OSPREY DR STE 325",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078069",
            "telephone_number": "503-579-5000",
            "fax_number": "503-579-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "503-579-5000",
            "fax_number": "503-579-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C BONOVICH MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-13",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "WADSWORTH",
        "authorized_official_first_name": "LEANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-579-5000"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "G71726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7587738",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel B. Allen, M.D., Inc.
• Robert Darnell Jr., D.D.S.
• Lillian Franchot Dashiell, DDS
• Garrett Christopher Daum, M.D.
• Jay Dave
• David C. Bradshaw, M.D. Apc
• Caleb Marques Davis
• Lloyd E Davis, LCSW
• Cynthia Michelle De la Torre
• Neil De Quant, DC

• Vascular Neurology Physician in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Vascular Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.