Individual
MR. JOHN GLENNFORD BACCARAY BONOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT
Contact information
Practice address
9333 IMPERIAL HWY, DOWNEY, CA 90242
(562) 657-8850
Mailing address
9333 IMPERIAL HWY, DOWNEY, CA 90242
(562) 657-8850
Taxonomy
Speciality
Code
Description
License number
State
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
Primary
22542
CA
Other
Enumeration date
09/01/2018
Last updated
09/01/2018
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