Individual
DR. JOSEPH A BONANNO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 SANTA FE DR, SUITE 204, ENCINITAS, CA 92024-5138
(760) 944-7300
(760) 633-3949
Mailing address
320 SANTA FE DR, SUITE 204, ENCINITAS, CA 92024-5138
(760) 944-7300
(760) 633-3949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G15782
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G157820
MEDI-CAL NUMBER
CA
Enumeration date
03/09/2006
Last updated
07/08/2007
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