Individual
DR. BROOKE KELLY BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
852 S GRAND AVE, GLENDORA, CA 91740-4806
(626) 914-4815
Mailing address
406 S WABASH AVE, GLENDORA, CA 91741-6221
(971) 258-8756
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34390
CA
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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