Bonifacio Coronel Fontanilla
Respiratory Therapist, Certified in Chino Hills, CA. Individual provider (NPI-1).
NPI number1063992014
StatusActive
Last updated in NPPESAug 20, 2018
Details
- NPI
- 1063992014
- Entity type
- Individual (NPI-1)
- Name
- Bonifacio Coronel Fontanilla
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 20, 2018
- Last updated
- Aug 20, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 227800000X | Respiratory Therapist, Certified | 14762 | CA | Yes |
Practice location
2363 Scenic Ridge DrChino Hills, CA 91709
Phone 909-210-1931
Mailing address
3440 E La Palma AveAnaheim, CA 92806-2020
Phone 714-644-7570
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