| Bonsana Medical Group | |
|
1287 Fulton Rd Santa Rosa CA 95401-4923 | |
| (707) 595-3133 | |
| Not Available |
| Full Name | Bonsana Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1287 Fulton Rd, Santa Rosa, California |
| Authorized Official Name and Position | Jon Sterngold (OWNER) |
| Authorized Official Contact | 7075953133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonsana Medical Group Po Box 1770 La Mesa CA 91944-1770 Ph: () - | Bonsana Medical Group 1287 Fulton Rd Santa Rosa CA 95401-4923 Ph: (707) 595-3133 |
| NPI Number | 1811490899 |
|---|---|
| Provider Enumeration Date | 03/15/2018 |
| Last Update Date | 06/04/2021 |
| Medicare PECOS PAC ID | 9436412954 |
|---|---|
| Medicare Enrollment ID | O20180416002800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811490899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel Steven Calder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629056130 PECOS PAC ID: 8921080649 Enrollment ID: I20040604000827 |
| Provider Name | Robert Thomas Isaacs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912927286 PECOS PAC ID: 7113935479 Enrollment ID: I20080426000048 |
| Provider Name | Barbara Joy Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356312763 PECOS PAC ID: 4789821703 Enrollment ID: I20130513000031 |
| Provider Name | Jon R Sterngold |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265664866 PECOS PAC ID: 5991947129 Enrollment ID: I20130816000612 |
| Provider Name | Mahedere Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588809651 PECOS PAC ID: 6709001910 Enrollment ID: I20140702000416 |
| Provider Name | Tiffany Figuero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174011928 PECOS PAC ID: 8123367554 Enrollment ID: I20190302000039 |
| Provider Name | Laura Denise Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730356692 PECOS PAC ID: 8921336348 Enrollment ID: I20190822004594 |
| Provider Name | Mary E Andich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093222408 PECOS PAC ID: 6002146107 Enrollment ID: I20191002001449 |
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