Individual
MIGUEL BONOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
221 WESTWOOD PLZ, LOS ANGELES, CA 90095-4103
(310) 825-4073
Mailing address
20849 GRETCHEN ST, WINNETKA, CA 91306-4016
(818) 800-0727
Taxonomy
Speciality
Code
Description
License number
State
163WC1400X
College Health Registered Nurse
Primary
RN95265374
CA
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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