Bonifacio, Mark Gerald M

Bonifacio, Mark Gerald M is an individual health care provider with primary practice located at 17742 Beach Blvd Ste 240 , Huntington Beach CA 92647-6835. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as his primary health care specialty. Bonifacio, Mark Gerald M can be contacted via phone (714) 842-0444.

Contact Information

Primary practice address
17742 Beach Blvd Ste 240 Huntington Beach CA 92647-6835
Phone: (714) 842-0444
Fax: (714) 842-8444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 95006060 California

Profile Details

NPI number 1528599867
LBN Legal business name Bonifacio, Mark Gerald M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2017
Last updated Jun 30th, 2026 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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