Active NPI
Norton Bongbong, PT
- Physical Therapist
- Pinole, CA
National Provider Identifier
1861098493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24680
- Practice address
- 2850 Estates Ave
Pinole, CA 94564-1416 - Phone
- (510) 758-1122
- NPI assigned
- Dec 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 24680 | CA | Primary |
Addresses
Primary practice location
2850 Estates Ave
Pinole, CA 94564-1416
Mailing address
1410 Greenfield Cir
Pinole, CA 94564-2138
Phone (510) 499-8206
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24680 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1861098493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1410 GREENFIELD CIR",
"city": "PINOLE",
"state": "CA",
"postal_code": "945642138",
"telephone_number": "510-499-8206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 ESTATES AVE",
"city": "PINOLE",
"state": "CA",
"postal_code": "945641416",
"telephone_number": "510-758-1122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONGBONG",
"first_name": "NORTON",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-09",
"last_updated": "2020-12-09",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "24680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinole, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.