Individual
GREGORY PAUL BONAGURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN-BC
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 445-7715
Mailing address
1860 11TH ST APT B, ARCATA, CA 95521-5493
(908) 812-8862
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN95168323
CA
Other
Enumeration date
07/24/2018
Last updated
09/07/2021
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