1679946446 NPI number — DONALD CHARLES BOND PHARMD, RPH

Table of content: DONALD CHARLES BOND PHARMD, RPH (NPI 1679946446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679946446 NPI number — DONALD CHARLES BOND PHARMD, RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOND
Provider First Name:
DONALD
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD, RPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679946446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
517 GREENBRIAR CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PETALUMA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94954-3538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-956-3943
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16405 HWY 116
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUERNEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-869-0613
Provider Business Practice Location Address Fax Number:
707-869-1945
Provider Enumeration Date:
11/02/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  71926 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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