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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023080744 | NPPES |
| Arizona | MEDICAID | 862913 |
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