MILDREDE BONGLACK MD NPI 1134612013

NPI Information

  • NPI: 1134612013
  • Provider Name: MILDREDE BONGLACK, MD
  • Classification: Obstetrics & Gynecology - 207VF0040X
  • Specialization: Urogynecology and Reconstructive Pelvic Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 797 W CHILDS AVE
    MERCED, CA
    ZIP 95341
  • Phone: (209) 384-6498

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NPI Details

Mildrede Bonglack, MD is an urogynecology and reconstructive pelvic surgery in Merced, CA with 8 years of experience. The provider is a subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. Mildrede Bonglack, MD NPI is 1134612013. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

797 W CHILDS AVE
MERCED, CA
ZIP 95341-805
Phone: (209) 384-6498
Fax: (209) 359-2045

The NPI 1134612013 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/14/2018 and was last updated on 10/16/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VF0040XObstetrics & GynecologyUrogynecology and Reconstructive Pelvic SurgeryA204492CALIFORNIAYes
2207V00000XObstetrics & Gynecology35.144536OHIONo
3207V00000XObstetrics & GynecologyR-11323IOWANo
4207V00000XObstetrics & Gynecology204492CALIFORNIANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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