Individual provider · NPI-1

Valerie Bonilla, PA-C

Physician Assistant · La Habra, CA

NPI number1083016125
StatusActive
Last updated in NPPESMar 6, 2020

Details

NPI
1083016125
Entity type
Individual (NPI-1)
Name
Ms. Valerie Bonilla
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Sep 19, 2014
Certification date
Mar 6, 2020
Last updated
Mar 6, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPA57881CAYes
363A00000X Physician AssistantPA 9108190FL

Practice location

1040 W Imperial Hwy
La Habra, CA 90631-0608

Phone 714-451-1072

Mailing address

1040 W Imperial Hwy
La Habra, CA 90631-0608

Phone 714-451-1072

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