Organization
BONNIE V. BOCK MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE VIRGINIA BOCK MD (PRESIDENT)
(949) 645-9010
Entity
Organization
Contact information
Practice address
1501 SUPERIOR AVE, SUITE 300, NEWPORT BEACH, CA 92663
(949) 645-9010
(949) 645-1003
Mailing address
1501 SUPERIOR AVE STE #300, NEWPORT BEACH, CA 92663
(949) 645-9010
(949) 645-1003
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
G35572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G355720
—
CA
Enumeration date
10/20/2006
Last updated
01/06/2014
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