DR. OLUWAMUYIWA BOLONDURO (NPI# 1215216965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215216965 |
| Entity Type | Individual |
| Full Name | DR. OLUWAMUYIWA BOLONDURO |
| Other Name | MUYIWA BOLORUNDURO |
| Credential | M.D |
| Practice Address |
742 W Highland Ave San Bernardino CA 92405-3839 |
| Practice Telephone | 9098817320 |
| Practice Fax Number | 9098817330 |
| Mailing Telephone | 9098817320 |
| Mailing Fax Number | 9098817330 |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2020-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 01078198A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PTAN | 191360022 | 01 |
| CA | 1215216965 | 05 | |
| IN | 300002192 | 05 |
| Street Address |
742 W HIGHLAND AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92405-3839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093789000 | Elaine Marie Gackle | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2006-02-15 |
| 1336789890 | Borrego Community Health Foundation | Clinic/Center | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2020-01-13 |
| 1841844990 | Karl Amparo | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2019-07-27 |
| 1760975825 | Ambika Ranabhat | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2018-06-12 |
| 1770074791 | Nomagugu Mafu | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2018-05-24 |
| 1083008254 | Maretha Tyce | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2015-03-25 |
| 1366831653 | Yoggie Efendy | Nurse Practitioner | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2015-01-09 |
| 1487932372 | Hobart Leung | Internal Medicine | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2011-07-27 |
| 1265744718 | Ray Lengvilas | Pediatrics | 742 W Highland Ave, San Bernardino, CA 92405-3839 | 2010-07-12 |
| 1396914545 | Philis Denise Ransom | Obstetrics & Gynecology | 742 W Highland Ave, San Bernardino, CA 92405 | 2008-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174177497 | New Hope Transitional Living | Clinical Nurse Specialist | 1228 West 31st, San Bernardino, CA 92405 | 2019-07-25 |
| 1336647494 | Paul J Iorio | Counselor | 1669 Norht E Street, San Bernardino, CA 92405 | 2018-01-24 |
| 1609385756 | Abraham Isacc Gonzalez | Registered Nurse | 255 W 17th St, San Bernardino, CA 92405 | 2017-09-20 |
| 1962945675 | Ann Marie Monica Clark | Assisted Living Facility | 3524 Acacia Avenue, San Bernardino, CA 92405 | 2016-11-29 |
| 1801265715 | Leslie Del Toro | Counselor | 2025 N D St, San Bernardino, CA 92405 | 2015-09-21 |
| 1558797324 | Nora Escobar-mandujano | Marriage & Family Therapist | 1441 North 'd' Street, San Bernardino, CA 92405 | 2013-09-24 |
| 1295088284 | Elizabeth Rocha | Counselor | 1669 North E Street, San Bernardino, CA 92405 | 2012-10-16 |
| 1972855237 | Vanessa Kelly Gutierrez | Marriage & Family Therapist | 1669 N E Street, San Bernardino, CA 92405 | 2012-10-11 |
| 1952664021 | Mosley Counseling Center, LLC | Counselor | 2130 W. Arrowhead Ave., Suite 103c, San Bernardino, CA 92405 | 2012-06-22 |
| 1508167602 | Al Shifa Clinic Incorporated | Voluntary or Charitable | 2334 North Sierra Way, San Bernardino, CA 92405 | 2010-11-06 |
| Find all providers in zip 92405 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982024436 | Pouya Abhari | Obstetrics & Gynecology | 1800 N. Western Ave, Suite 204, San Bernardino, CA 92411-1353 | 2014-04-23 |
| 1003140948 | Joe Mawad | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411 | 2009-09-24 |
| 1053599936 | Jeanne M. Rorabeck | Obstetrics & Gynecology | 172 W 3rd St, San Bernardino, CA 92415 | 2008-02-04 |
| 1811197536 | Chang Li Lee | Obstetrics & Gynecology | 399 E Highland Ave Ste 223, San Bernardino, CA 92404-3864 | 2007-07-20 |
| 1104835388 | Peter T Yang | Obstetrics & Gynecology | 399 E Highland Ave Ste 516, San Bernardino, CA 92404-3875 | 2006-08-05 |
| 1174550511 | Morton Paul Hibbert | Obstetrics & Gynecology | 665 N D St, San Bernardino, CA 92401-1109 | 2006-06-28 |
| 1871553347 | Woman To Woman Ob Gyn Medical Grp | Obstetrics & Gynecology | 249 E Highland Ave, Patricia, San Bernardino, CA 92404-3707 | 2006-03-27 |
| 1912561325 | Nelly Sandoval | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411-1353 | 2019-05-01 |
| 1588229934 | Martha G Sanchez | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411-1353 | 2019-05-01 |
| 1962898254 | Marie Romero | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411-1353 | 2015-04-13 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.