Healthcare Provider Details

I. General information

NPI: 1588916381
Provider Name (Legal Business Name): BREA BONDI-BOYD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 02/11/2022
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA AVE
MARTINEZ CA
94553
US

IV. Provider business mailing address

1800 HARRISON ST, 7TH FL
OAKLAND CA
94612-3429
US

V. Phone/Fax

Practice location:
  • Phone: 925-370-5200
  • Fax:
Mailing address:
  • Phone: 510-625-2856
  • Fax: 877-738-4262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA122806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: