DR. ROBERT BONNER (NPI# 1992706220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992706220 |
| Entity Type | Individual |
| Full Name | DR. ROBERT BONNER |
| Credential | O.D. |
| Practice Address |
14595 Olympic Dr Clearlake CA 95422-9100 |
| Practice Telephone | 7079941488 |
| Practice Fax Number | 7079948108 |
| Mailing Telephone | 7079941488 |
| Mailing Fax Number | 7079948108 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2008-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 5079T | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SD0050790 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093946311 | Robert Emmett Bonner | Preventive Medicine | 690 Asylum Ave, T9-106, Hartford, CT 06115 | 2009-08-04 |
| 1295814267 | Robert Louis Bonner Jr. | Pediatrics | 5501 Old York Rd, Philadelphia, PA 19141-3018 | 2006-11-02 |
| 1497862684 | Robert Arthur Bonner | Internal Medicine | 3975 Jackson St, Suite 107, Riverside, CA 92503-3901 | 2006-08-24 |
| Street Address |
14595 OLYMPIC DR |
| City | CLEARLAKE |
| State | CA |
| Zip Code | 95422-9100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831729201 | Richard Charles Hammond | Counselor | 7000 B South Center Drive, Clearlake, CA 95422 | 2020-01-24 |
| 1609416437 | Junirose Thom | Behavioral Analyst | 4456 Manzanita Avenue Suite 2, Clearlake, CA 95422 | 2020-01-09 |
| 1649781360 | Lake County Office of Education | Local Education Agency (LEA) | 3350 Acacia St, Clearlake, CA 95422 | 2017-10-20 |
| 1083091326 | Noelle Menesini | Physician Assistant | 15230 Lake Shore Drive, Clearlake, CA 95422 | 2015-05-06 |
| 1861820979 | Lake County Office of Education | Local Education Agency (LEA) | 6945 Old Highway 53, Clearlake, CA 95422 | 2013-10-29 |
| 1124469838 | Hassan Sheikh Moghaddas | Surgery | 15332 Lakeshore Dr Ste 101, Clearlake, CA 95422 | 2013-07-10 |
| 1366710279 | Nancy Bylund | Licensed Psychiatric Technician | 7000b South Center Drive, Clearlake, CA 95422 | 2011-12-06 |
| 1699060830 | Planned Parenthood Shasta Pacific | Clinic/Center | 1437 Olympic Drive, Cleaklake, CA 95422 | 2011-06-16 |
| 1164655247 | Hector Lara | Counselor | 14130 Lakeshore Dr., Clearlake, CA 95422 | 2009-08-24 |
| 1518197607 | Vishal V Desai | Pharmacist | 15025, Olympic Drive, Clearlake, CA 95422 | 2009-07-23 |
| Find all providers in zip 95422 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164932976 | Jack M. Elizares Optometric Corporation | Optometrist | 3610 Old Hwy 53, Clearlake, CA 95422-9543 | 2017-10-06 |
| 1295715712 | Jack M Elizares | Optometrist | 3610 Old Highway 53, Clearlake, CA 95422-9253 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183428 | Ashley Park | Optometrist | 386 S Green Valley Rd Ste 2, Watsonville, CA 95076-3007 | 2020-10-30 |
| 1053911842 | Michael Guerret | Optometrist | 4130 N Viking Way # 110, Long Beach, CA 90808-1402 | 2020-10-29 |
| 1912506155 | Minati Desai Acharya, O.d., Optometric Corporation | Optometrist | 117 Pelton Center Way, San Leandro, CA 94577-4815 | 2020-10-20 |
| 1740888627 | Jennifer Ngo | Optometrist | 3217 W 153rd St, Gardena, CA 90249-4011 | 2020-10-13 |
| 1649878521 | Jennie Lin | Optometrist | 12914 Cranleigh St, Cerritos, CA 90703-7245 | 2020-10-13 |
| 1962009464 | Jyoti Patel | Optometrist | 1701 Gaffey St., San Pedro, CA 90731 | 2020-10-07 |
| 1114524196 | Kenneth E. Sweeney, O.d., Inc. | Optometrist | 825 Pollard Rd Ste 208, Los Gatos, CA 95032-1435 | 2020-10-03 |
| 1316544364 | Chelsey Kimiko Honma | Optometrist | 3151 Airway Ave Ste M3, Costa Mesa, CA 92626-4626 | 2020-10-02 |
| 1437766920 | Mary Mekhael | Optometrist | 5901 Center Dr Apt 456, Los Angeles, CA 90045-8969 | 2020-09-28 |
| 1013524677 | Jennifer Dang, O.d., A Professional Corporation | Optometrist | 301 S Western Ave Ste 103, Los Angeles, CA 90020-3816 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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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.