GREGORY RALPH BONOMO (NPI# 1831295823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831295823 |
| Entity Type | Individual |
| Full Name | GREGORY RALPH BONOMO |
| Credential | MD |
| Practice Address |
1650 Adams Ave Costa Mesa CA 92626-4958 |
| Practice Telephone | 7145496500 |
| Mailing Telephone | 7145496500 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2009-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
G22382 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G223820 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740375567 | Gregory Allen Bonomo | Physical Therapist | 9120 Church St, Rancho Cucamonga, CA 91730-2103 | 2006-10-04 |
| Street Address |
1650 ADAMS AVE |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013561752 | Tiffany Tabares | Counselor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2019-07-31 |
| 1821642570 | Anasa Jamala Storay-demby | Counselor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2019-07-31 |
| 1568994515 | Wired Clean, LLC | Community/Behavioral Health | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2017-03-29 |
| 1003155896 | Clean Testing Services | Clinical Medical Laboratory | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2013-02-14 |
| 1639323520 | South Coast Rehabilitation Center | Chiropractor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2008-11-05 |
| 1134259468 | Griffin Medical Group | Specialist | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2007-03-06 |
| 1033251418 | Alan Craig Ivar | Chiropractor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2007-02-13 |
| 1629158514 | Alvin M Yee | General Practice | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720222631 | Scott S. Ferer, M.d., A Medical Corporation | Psychiatry & Neurology | 2216 Newport Blvd, Costa Mesa, CA 92627-1711 | 2009-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497352876 | Riverside Optimal Healthcare, Inc | Psychiatry & Neurology | 13320 Riverside Dr Ste 204, Sherman Oaks, CA 91423-2512 | 2020-10-08 |
| 1710592431 | Muhammad Amin | Psychiatry & Neurology | 33433 Pony Loop, Fremont, CA 94555-3511 | 2020-09-10 |
| 1558973792 | Catalyst Neuromedical Center PC | Psychiatry & Neurology | 3305 Placer St Ste B, Redding, CA 96001-2378 | 2020-08-19 |
| 1134730906 | West Coast Valley Medical Inc | Psychiatry & Neurology | 3357 Cahuenga Blvd W # 18, Los Angeles, CA 90068-1327 | 2020-08-13 |
| 1720603582 | Lily Wenya Zhou | Psychiatry & Neurology | 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 | 2020-06-08 |
| 1760015689 | Simon James Little | Psychiatry & Neurology | 1634 Divisadero St, Suite 250, San Francisco, CA 94115 | 2020-02-19 |
| 1427689256 | Alejandro F Centurion Md Inc | Psychiatry & Neurology | 100 Clock Tower Pl Ste 225, Carmel, CA 93923-8778 | 2020-01-30 |
| 1659901254 | Kern County Neurological Medical Group, Inc | Psychiatry & Neurology | 18645 Gale Ave Ste 228b, City of Industry, CA 91748-1363 | 2020-01-22 |
| 1609415314 | Aspire Holdings, Inc | Psychiatry & Neurology | 28212 Kelly Johnson Pkwy Ste 215, Valencia, CA 91355-5090 | 2019-12-27 |
| 1336785187 | Tp-health Ca PC | Psychiatry & Neurology | 201 E Center St Ste 112, Anaheim, CA 92805-7212 | 2019-11-26 |
| Find all providers with the same taxonomy | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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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.