MEDICARE: BONES MANAGEMENT, INC.

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
1	3336C0003X	Community/Retail Pharmacy	PHY34719	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0533326	OTHER	CA	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326158528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BONES MANAGEMENT, INC.

Provider Business Mailing Address
First Line	:	14241 FIRESTONE BLVD
Second Line	:	SUITE 320
City	:	LA MIRADA
State	:	CA
Zip	:	90638-5530
Country	:	US
Telephone Number	:	562-407-9338
Fax Number	:	562-407-9340

Provider Business Practice Location Address
First Line	:	210 S GRAND AVE
Second Line	:	SUITE 116
City	:	GLENDORA
State	:	CA
Zip	:	91741-4205
Country	:	US
Telephone Number	:	626-335-2300
Fax Number	:	626-914-0713

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL GLOBERMAN
Credential	:
Telephone Number	:	562-407-9338

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/26/2015

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Directions to “BONES MANAGEMENT, INC. ” Practice Location

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