Bonita Cardiovascular Med GRP Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A30915 Issued in CA

Legal business name

BONITA CARDIOVASCULAR MED GRP INC

Practice address

3916 Palm Drive
Bonita, CA 91902

Phone

(619) 267-6922

Fax

(619) 267-2013

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lorenzo Gonzalez Lavin, MD

Title

President

Phone

(619) 267-6922

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1528126190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1534",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919081534",
            "telephone_number": "619-267-6922",
            "fax_number": "619-267-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 PALM DRIVE",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "91902",
            "telephone_number": "619-267-6922",
            "fax_number": "619-267-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONITA CARDIOVASCULAR MED GRP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ LAVIN",
        "authorized_official_first_name": "LORENZO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-267-6922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A30915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A30951",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Bonita, CA
• Providers in Bonita, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.