Individual provider Active NPI

Lawrence Paul Bonaldi, M.D.

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1851379796
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G34176 Issued in CA
Practice address
750 Story Rd Ste 13
San Jose, CA 95122-2604
Phone
(408) 850-5948
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 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 G34176 CA Primary

Addresses

Primary practice location

750 Story Rd Ste 13
San Jose, CA 95122-2604

Mailing address

750 Story Rd Ste 13
San Jose, CA 95122-2604
Phone (408) 850-5948

Other identifiers 1

IdentifierTypeStateIssuer
942609963OtherARFEDERAL TAX I.D. NUMBER

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
I20050929000661 CA Practitioner - Internal Medicine 5991730830 Reassigns benefits to 1 organization
Practice locations: Campbell, CA; Milpitas, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G34176CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Your Community Care CurrentSince Apr 13, 2025 Accepting new patients
Vitas Health Services of California Inc CurrentSince Nov 23, 2015 Accepting new patients

Locations

1343 N Grand Ave
Ste 100
Covina, CA 91724
Phone (626) 918-2273

670 N McCarthy Blvd
Ste 220
Milpitas, CA 95035
Phone (408) 582-4113

750 Story Rd
Ste 13
San Jose, CA 95122
Phone (408) 850-5948

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

255 E 5th St
Ste 1050
Cincinnati, OH 45202

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.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1851379796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 STORY RD STE 13",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222604",
            "telephone_number": "408-850-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 STORY RD STE 13",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222604",
            "telephone_number": "408-850-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONALDI",
        "first_name": "LAWRENCE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G34176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX I.D. NUMBER",
            "identifier": "942609963",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.