Individual provider Active NPI

Antonio Caragay Bondoc, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Palo Alto, CA
National Provider Identifier
1972725893
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 14149 Issued in CA
Practice address
3801 Miranda Avenue
Veterans Administration Palo Alto Healthcare System
Palo Alto, CA 94304-1290
Phone
(650) 849-0287
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 14149 CA Primary

Addresses

Primary practice location

3801 Miranda Avenue
Veterans Administration Palo Alto Healthcare System
Palo Alto, CA 94304-1290

Mailing address

2107 42ND Avenue
San Francisco, CA 94116
Phone (415) 260-6871

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

LicenseStateTypeSpecialty
PA 14149CAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1972725893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 42ND AVENUE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94116",
            "telephone_number": "415-260-6871",
            "fax_number": "415-618-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVENUE",
            "address_2": "VETERANS ADMINISTRATION PALO ALTO HEALTHCARE SYSTEM",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041290",
            "telephone_number": "650-849-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDOC",
        "first_name": "ANTONIO",
        "middle_name": "CARAGAY",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 14149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.