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Monique Bonilla

NPI Registration Record

Provider / OrganizationNPIDate Certified
MONIQUE BONILLA14973722392020-06-27
Entity TypeIndividual
Provider NameMiss Monique Bonilla LVN
Practice Office Address2644 30TH ST STE 100
SANTA MONICA, CA US
Practice Office Telephone3103146200
Mailing Address2644 30TH ST STE 100
SANTA MONICA, CA 904053051 US
HPT Codes
CodeLicense NoState
164X00000X PRIMARYVN699382 CA
OPI Codes

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