Bonnie Nickel, M.D,

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

00G362480 Issued in CA

Legal business name

BONNIE NICKEL, M.D,

Practice address

750 Las Gallinas Ave
Suite #114
San Rafael, CA 94903-3438

Phone

(415) 492-0950

Fax

(415) 492-9029

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bonnie Lynn Nickel, M.D.NPI 1881874709

Title

Owner

Phone

(415) 492-0950

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Bonnie Lynn Nickel, M.D.

  • Ophthalmology Physician
  • San Rafael, CA
  • NPI 1881874709
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1649349283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE",
            "address_2": "SUITE #114",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033438",
            "telephone_number": "415-492-0950",
            "fax_number": "415-492-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE",
            "address_2": "SUITE #114",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033438",
            "telephone_number": "415-492-0950",
            "fax_number": "415-492-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIE NICKEL, M.D,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "NICKEL",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-492-0950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "00G362480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Bojarski-Rapp, PTA
• Tamara Bolinger, R.N.
• Laura Bolles
• Stefanie Jean Bond, AMFT
• Michelle Denise Bonner
• Charles Bookoff, MD
• Robert Dennis Bordeaux, MFTI
• Martin J Borge, D.C.
• Lani Susan Borgwardt
• Sydne K Bortel, MSW

• Ophthalmology Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.