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NPI Code Detail

MEDICARE: DR. PHILIP A BONANNO MD

MEDICARE: DR. PHILIP A BONANNO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician307659NY
22084P0800XPsychiatry Physician61450297WA
32084P0800XPsychiatry Physician185592CA

General Provider Information

NPI Number : 1760942437
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP A BONANNO MD
Provider Business Mailing Address
First Line : 298 SAN ANTONIO RD STE 100
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-5309
Country : US
Telephone Number :
Fax Number : 925-281-3283
Provider Business Practice Location Address
First Line : 298 SAN ANTONIO RD STE 100
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-5309
Country : US
Telephone Number : 650-446-4900
Fax Number : 925-281-3283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2019
Last Update Date : 01/22/2025

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Directions to “ DR. PHILIP A BONANNO MD” Practice Location

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