Organization
SOUTHWEST COMPREHENSIVE PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIEL LUIS BONILLA MD (MEDICAL DIRECTOR AND LLC MEMBER)
(623) 780-1563
Entity
Organization
Contact information
Practice address
1749 W BRAMBLE BERRY LN, PHOENIX, AZ 85085-8044
(623) 780-1563
Mailing address
1749 W BRAMBLE BERRY LN, PHOENIX, AZ 85085-8044
(623) 780-1563
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
32912
AZ
Other
Enumeration date
05/14/2008
Last updated
03/07/2023
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