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Individual

EDWARD XAVIER BONILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
3989 W STETSON AVE STE 105, HEMET, CA 92545-9697
(951) 652-3334
Mailing address
24630 WASHINGTON AVE STE 201, MURRIETA, CA 92562-6177
(951) 200-3620

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22784
CA

Other

Enumeration date
10/07/2021
Last updated
10/07/2021
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