Provider Demographics
NPI:1972725893
Name:BONDOC, ANTONIO CARAGAY (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:CARAGAY
Last Name:BONDOC
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 42ND AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116
Mailing Address - Country:US
Mailing Address - Phone:415-260-6871
Mailing Address - Fax:415-618-3103
Practice Address - Street 1:3801 MIRANDA AVENUE
Practice Address - Street 2:VETERANS ADMINISTRATION PALO ALTO HEALTHCARE SYSTEM
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1290
Practice Address - Country:US
Practice Address - Phone:650-849-0287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 14149363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical