Provider Demographics
NPI:1083766869
Name:BONGOLAN, FRANK ELIZARDE JR (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ELIZARDE
Last Name:BONGOLAN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:PO BOX 596
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-0596
Mailing Address - Country:US
Mailing Address - Phone:925-596-1100
Mailing Address - Fax:925-362-1726
Practice Address - Street 1:425 EL PINTADO RD
Practice Address - Street 2:STE. 180
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1848
Practice Address - Country:US
Practice Address - Phone:925-596-1100
Practice Address - Fax:925-328-1138
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2011-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CADC28772111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition