Healthcare Provider Details

I. General information

NPI: 1245330331
Provider Name (Legal Business Name): BARBARA LYNNE BOND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

PO BOX 661597
ARCADIA CA
91066-1597
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-4564
  • Fax: 510-437-4564
Mailing address:
  • Phone: 626-447-0296
  • Fax: 626-447-6057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA90591
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: