Individual provider Active NPI

David Alfonso Bolivar, M.D.

  • Internal Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1801830609
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A33373 Issued in CA
Practice address
598 N F St
San Bernardino, CA 92410-3110
Phone
(909) 888-8152
Fax
(909) 884-7530
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A33373 CA Primary

Addresses

Primary practice location

598 N F St
San Bernardino, CA 92410-3110

Mailing address

598 N F St
San Bernardino, CA 92410-3110
Phone (951) 351-1600

Other identifiers 2

IdentifierTypeStateIssuer
00A333732MedicaidCA
00A333730MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040301000837 CA Practitioner - Emergency MedicinePractitioner - Internal Medicine 1355238718 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

598 N F St
San Bernardino, CA 92410-3110
Phone (909) 793-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A33373CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bolivar Family Medical Clinic a Medical Corporation CurrentSince Dec 16, 2013 Accepting new patients
Bolivar Family Medical Clinic a Medical Corporation CurrentSince Dec 16, 2013 Accepting new patients
Quality Care Ipa Inland Empire, Inc CurrentSince Mar 12, 2014 Accepting new patients
Parkview Hospital, Inc. Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

10327 Hole Ave
Riverside, CA 92505
Phone (909) 351-1600

590 N Sierra Way
San Bernardino, CA 92410
Phone (909) 327-4700

598 N F St
Sn Bernrdno, CA 92410
Phone (909) 888-8152

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1801830609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 N F ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103110",
            "telephone_number": "951-351-1600",
            "fax_number": "951-351-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 N F ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103110",
            "telephone_number": "909-888-8152",
            "fax_number": "909-884-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR",
        "first_name": "DAVID",
        "middle_name": "ALFONSO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A33373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A333732",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A333730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.