Individual
DR. SHEILA MARIE BONILLA-TANDOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MS
Contact information
Practice address
1520 SAN PABLO ST STE 1000, LOS ANGELES, CA 90033-5312
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5100
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
A69281
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A692810
BLUE SHIELD
CA
05
—
00A692810
—
CA
01
—
00A692810197
CAL OPTIMA
CA
01
—
1356390009
GROUP NPI
CA
01
—
CE1617
GROUP RAILROAD MEDICARE
CA
01
—
GR0016910
GROUP MEDICAID PIN
CA
01
—
W11675
GROUP MEDICARE PIN
CA
Enumeration date
06/25/2006
Last updated
07/17/2025
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