Provider Demographics
NPI:1992780787
Name:BONEKAT, H WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:H
Middle Name:WILLIAM
Last Name:BONEKAT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 V ST
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-3564
Mailing Address - Fax:916-734-7924
Practice Address - Street 1:4150 V ST
Practice Address - Street 2:SUITE 3400
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-3564
Practice Address - Fax:916-734-7924
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA020A55660207R00000X, 207RP1001X
CAA55660207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAX55660Medicaid
E45333Medicare UPIN
CA20A55660Medicare ID - Type Unspecified