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General NPI Number Information
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NPI Number | 1972725893
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Entity Type | Individual
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Provider Name | ANTONIO CARAGAY BONDOC PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 3801 MIRANDA AVENUE VETERANS ADMINISTRATION PALO ALTO HEALTHCARE SYSTEM
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City | PALO ALTO
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State | CA
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Zip | 94304-1290
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Country | US
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Telephone | 650-849-0287
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 42ND AVENUE
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City | SAN FRANCISCO
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State | CA
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Zip | 94116
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Country | US
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Telephone | 415-260-6871
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Fax | 415-618-3103
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA 14149
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License Number State | CA
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