Individual
BOBBY BONGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2934 VISTA ST NE, WASHINGTON, DC 20018-2636
(202) 423-5599
Mailing address
2934 VISTA ST NE, WASHINGTON, DC 20018-2636
(202) 423-5599
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/27/2014
Last updated
02/26/2025
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