Individual
BONIFACIO CORONEL FONTANILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2363 SCENIC RIDGE DR, CHINO HILLS, CA 91709
(909) 210-1931
Mailing address
3440 E LA PALMA AVE, ANAHEIM, CA 92806-2020
(714) 644-7570
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
14762
CA
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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