Bonomo, Gregory Ralph
Bonomo, Gregory Ralph is an sole proprietor health care provider with primary practice located at 1650 Adams Ave , Costa Mesa CA 92626-4958. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Bonomo, Gregory Ralph can be contacted via phone (714) 549-6500.Contact Information
Primary practice address
1650 Adams Ave
Costa Mesa CA 92626-4958
Phone: (714) 549-6500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | G22382 | California |
Profile Details
| NPI number | 1831295823 |
|---|---|
| LBN Legal business name | Bonomo, Gregory Ralph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Jan 15th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831295823 | NPPES |
| California | MEDICAID | 00G223820 |
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