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Individual

DR. DAYNE KAWIKA BONZO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2630 CENTRAL AVE # 3349, EIELSON AFB, AK 99702-2301
(907) 377-6455
Mailing address
2360 CENTRAL AVE #3349, ATTN DR. DAYNE BONZO, EIELSON AFB, AK 99702
(907) 377-6455

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34.013112
OH
208D00000X
General Practice Physician
34.013112
OH
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/13/2016
Last updated
08/25/2022
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