Mangunsong, Bonar Sofian

Mangunsong, Bonar Sofian is an sole proprietor health care provider with primary practice located at 25340 Park Ave Apt 6 , Loma Linda CA 92354. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mangunsong, Bonar Sofian can be contacted via phone (909) 252-6481.

Contact Information

Primary practice address
25340 Park Ave Apt 6 Loma Linda CA 92354
Phone: (909) 252-6481
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 52249 California

Profile Details

NPI number 1437548880
LBN Legal business name Mangunsong, Bonar Sofian
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2015
Last updated Jan 22nd, 2015 - about 11 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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