MEDICARE: UROGYNECOLOGY ASSOCIATES, A MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208800000X	Urology Physician
2	261QM0850X	Adult Mental Health Clinic/Center
3	207R00000X	Internal Medicine Physician
4	207VG0400X	Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A66385	OTHER	CA	CALIFORNIA MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770736456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROGYNECOLOGY ASSOCIATES, A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	82 CINNAMON TEAL
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-1835
Country	:	US
Telephone Number	:	657-888-3008
Fax Number	:	657-888-9181

Provider Business Practice Location Address
First Line	:	1711 W TEMPLE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-7329
Country	:	US
Telephone Number	:	657-888-3008
Fax Number	:	657-888-9181

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ARAM BONNI
Credential	:	MD
Telephone Number	:	760-265-4500

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	02/07/2025

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