Individual
EDGAR BONGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1776 E CENTURY BLVD, LOS ANGELES, CA 90002-3050
(323) 374-6848
Mailing address
688 N RIMSDALE AVE APT 87, COVINA, CA 91722-3553
(626) 922-5280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
591690
CA
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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