MARK GERALD M BONIFACIO NP - NPI 1528599867 - Nurse Practitioner in Huntington Beach, CA

Q: What is Mark Gerald Bonifacio's NPI number?

The NPI number for Mark Gerald Bonifacio is 1528599867. It was assigned to this individual provider in the NPPES registry on March 27, 2017.

Q: What is Mark Gerald Bonifacio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

On this page

About Mark Gerald M Bonifacio Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK GERALD M BONIFACIO NP (NPI 1528599867) is an individual pediatrics provider in Huntington Beach, California, licensed in California (95006060) and active in the NPI registry since March 2017.

NPPES Registry Identity

NPI1528599867

Entity TypeIndividualMale

Primary Taxonomy363LP0200X

Provider Legal NameMARK GERALD M BONIFACIOCredential: NP

Location Address17742 BEACH BLVD STE 240Huntington Beach, CA 92647-6835

Mailing Address17742 Beach Blvd Ste 240Huntington Beach, CA 92647-6835 · (714) 842-0444 · Fax (714) 842-8444

Phone(714) 842-0444

Fax(714) 842-8444

Sole ProprietorNo

Enumeration DateMarch 27, 2017

Last NPPES UpdateJune 30, 20262 updates tracked since enumeration

NPPES CertifiedJune 30, 2026

✔ NPI 1528599867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in CA · 95006060

17742 BEACH BLVD STE 240, Huntington Beach, CA 92647

Open in Google Maps ↗

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE TIOLECO-CHENG M.D.

Pediatrics