Provider Demographics
NPI:1215197199
Name:BONZON, CHRISTOPHER JEFFREY (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JEFFREY
Last Name:BONZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SEAPORT COURT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2767
Mailing Address - Country:US
Mailing Address - Phone:650-995-1259
Mailing Address - Fax:650-995-1262
Practice Address - Street 1:400 SEAPORT COURT
Practice Address - Street 2:SUITE 201
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2767
Practice Address - Country:US
Practice Address - Phone:650-995-1259
Practice Address - Fax:650-995-1262
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124945208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation