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Individual

MICHAEL L. BONIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4405 VANDEVER AVE, SAN DIEGO, CA 92120-3315
(619) 528-5000
Mailing address
393 E WALNUT ST, 3RD FLOOR PHR SYSTEMS, PASADENA, CA 91188-0001
(626) 405-3640
(626) 405-6768

Taxonomy

Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
G28187
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G281870
CA
Enumeration date
01/08/2007
Last updated
07/08/2007
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