NPI 1023535820
Dennis Bonavilla
Practice location
- Address
- 34859 Frederick Street Suite 112, Wildomar, CA 92595
- Phone
- (951) 897-0770
- Mailing address
- 34859 Frederick St STE 112, Wildomar, CA 92595-7007
Registered specialties
Electroneurodiagnostic Specialist/Technologist
Primary
Registry record
- NPI
- 1023535820
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 23 Aug 2017
- Record last updated
- 23 Aug 2017
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.