Bonilla, Gabriel L

Bonilla, Gabriel L is an individual health care provider with primary practice located at 2526 W Rancho Laredo Dr , Phoenix AZ 85085-7168. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Bonilla, Gabriel L can be contacted via phone (928) 600-6762.

Contact Information

Primary practice address
2526 W Rancho Laredo Dr Phoenix AZ 85085-7168
Phone: (928) 600-6762
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 32912 Arizona

Profile Details

NPI number 1023080744
LBN Legal business name Bonilla, Gabriel L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated May 1st, 2020 - about 6 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1023080744 NPPES
Arizona MEDICAID 862913

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