Individual provider · Type 1 NPI
Dennis Bonavilla
Electroneurodiagnostic Specialist/Technologist · Wildomar, CA
NPI number
1023535820
Active
Practice location
34859 Frederick Street, Suite 112
Wildomar, CA 92595
Mailing address
34859 Frederick St Ste 112
Wildomar, CA 92595-7007
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Electroneurodiagnostic Specialist/Technologist Primary | 246ZE0600X | None listed |
Electroneurodiagnostic Specialist/Technologist: Definition to come...
About NPI 1023535820
Dennis Bonavilla's National Provider Identifier is 1023535820, issued on Aug 23, 2017. The primary taxonomy on file is Electroneurodiagnostic Specialist/Technologist (246ZE0600X), and the practice location is in Wildomar, CA. The record was last updated on Aug 23, 2017.