Individual
BRIAN CHRISTOPHER BONNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
30141 ANTELOPE RD, SUITE A, MENIFEE, CA 92584-7001
(951) 723-1866
(951) 723-1867
Mailing address
24630 WASHINGTON AVE, SUITE 200, MURRIETA, CA 92562-6177
(951) 696-9353
(951) 973-7216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT37413
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT374130
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
12/14/2010
Last updated
10/15/2014
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