| John Jayson Lopez Bongga, | |
|
400 N Pepper Ave, Colton, CA 92324-1801 | |
| (909) 580-2440 | |
| Not Available |
| Full Name | John Jayson Lopez Bongga |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 8 Years |
| Location | 400 N Pepper Ave, Colton, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710431960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 95000665 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northwest Specialty Hospital | Post falls, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Anesthesia Associates Of Coeur D Alene Pllc | 2365427838 | 47 |
| River City Anesthesia Associates Pllc | 4385534445 | 15 |
| Entity Name | River City Anesthesia Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114908993 PECOS PAC ID: 4385534445 Enrollment ID: O20040319001270 |
| Entity Name | Anesthesia Associates Of Coeur D Alene Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962440966 PECOS PAC ID: 2365427838 Enrollment ID: O20040621000475 |
| Mailing Address | Practice Location Address |
|---|---|
| John Jayson Lopez Bongga, 11755 Malaga Dr, Unit 1165, Rancho Cucamonga, CA 91730-7224 Ph: (909) 851-3067 | John Jayson Lopez Bongga, 400 N Pepper Ave, Colton, CA 92324-1801 Ph: (909) 580-2440 |
Mr. Richard William Reis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 North Pepper Avenue 2nd Floor, Anesthesia Dept., Inland Empire Anesthesia Medical Group, Inc., Colton, CA 92324 Phone: 909-580-2440 Fax: 909-580-2441 | |
Elizabeth Karenina Manullang, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 877-873-2762 | |
Ivan Stiger, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-2440 | |
Mr. Michael T Reid, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 900 E Washington St, Ste. 100, Colton, CA 92324 Phone: 909-370-2190 | |
Daniel Hioe, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-2440 | |
Mr. Dale Arthur Reile, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 400 N Pepper Ave Fl 2, Inland Empire Anesthesia Medical Group, Inc., Colton, CA 92324 Phone: 909-580-2440 Fax: 909-580-2441 | |
Cheryl Sisler Carr, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 400 N Pepper Ave, Anesthesia Dept, 2nd Floor, Colton, CA 92324 Phone: 909-580-2440 |