Active NPI
Maria Annie Shaner Sumayao Bongalon, D.C.
- Rehabilitation Chiropractor
- Sunnyvale, CA
National Provider Identifier
1811141393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 31001
- Practice address
- 1214 Apollo Way
Suite 401
Sunnyvale, CA 94085-5413 - Phone
- (408) 733-1032
- Fax
- (408) 733-0000
- NPI assigned
- Nov 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 31001 | CA | Primary |
Addresses
Primary practice location
1214 Apollo Way
Suite 401
Sunnyvale, CA 94085-5413
Mailing address
1214 Apollo Way
Suite 401
Sunnyvale, CA 94085-5413
Phone (408) 733-1032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31001 | CA | MD | Rehabilitation Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Medical Center, Inc. | Past | Accepting new patients | |
| Dynamic Medical Corporation | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Sunnyvale, CA
- NPI 1801845888
-
- Physical Medicine & Rehabilitation Physician
- San Francisco, CA
- NPI 1376592253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226275200000",
"number": "1811141393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 APOLLO WAY",
"address_2": "SUITE 401",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940855413",
"telephone_number": "408-733-1032",
"fax_number": "408-733-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1214 APOLLO WAY",
"address_2": "SUITE 401",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940855413",
"telephone_number": "408-733-1032",
"fax_number": "408-733-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONGALON",
"first_name": "MARIA ANNIE SHANER",
"middle_name": "SUMAYAO",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-10",
"last_updated": "2008-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "31001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.