Carla Marie Onglengco Bozon, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A188298 Issued in CA

Practice address

45124 10TH St W
Lancaster, CA 93534-2310

Phone

(562) 867-7999

NPI assigned

Jun 16, 2020

Reactivated

Feb 24, 2022

Last updated

Sep 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carla.bozonmd.p1@direct.jwch.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JWCH Institute Inc

  dba JWCH Institute Inc Medical Clinic Weingart Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1407808058
  Medicare reassignment NPD
• JWCH Institute Inc

  dba Wesley Health Centers - Health and Wellness Center 2

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
  • NPI 1073209177
  NPD
• JWCH Institute, Inc.

  dba Wesley Health Centers (Vermont)

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1598829350
  NPD
• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  NPD (past)
• Lancaster Hospital Corporation

  dba Palmdale Regional Medical Center

  • Rehabilitation Hospital Unit
  • Palmdale, CA
  • NPI 1033109947
  NPD (past)

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1639794670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45124 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "562-867-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45124 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "562-867-7999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45104 10th St W",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935342310",
            "country_code": "US",
            "telephone_number": "562-867-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOZON",
        "first_name": "CARLA MARIE",
        "middle_name": "ONGLENGCO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "deactivation_date": "2022-01-18",
        "reactivation_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A188298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amaya Boyd
• Bradford Moore Boyd Jr., DDS
• John Boyd
• Tab A. Boyle, D.D.S.
• Gerardo Bozikovic Jr.
• Bradford Boyd, DDS, Inc
• Monique Valmajean Bradford-McCree
• Paul Martin Bradford, RRW
• Rachel Nicole Bradford, CLC/E
• Jessica Bradley, PPS

• Pediatrics Physician in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.