David R. Boniface, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6874T Issued in CA

Practice address

329 W 2ND St
Calexico, CA 92231-2114

Phone

(760) 357-2712

Fax

(760) 357-5710

NPI assigned

Aug 21, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992810592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 W 2ND ST",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "922312114",
            "telephone_number": "760-357-2712",
            "fax_number": "760-357-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 W 2ND ST",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "922312114",
            "telephone_number": "760-357-2712",
            "fax_number": "760-357-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIFACE",
        "first_name": "DAVID",
        "middle_name": "R.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6874T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0068740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Michelle Bean, M.D.
• Nashallah Iesha Bell
• Bio-Medical Applications of California, Inc. (Fresenius Medical Care Calexico Dialysis)
• John E Bohm, M.D.
• Dustin Lee Bonham, P.T.
• Chip Booher, FNP
• Ariana Brambila
• Wendy Berenice Buzo Perez, NP
• Jose Guadalupe Caballero
• Cade

• Optometrist in Calexico, CA
• Providers in Calexico, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.