Bonnville, Heather K

Bonnville, Heather K is an individual health care provider with primary practice located at 661 W 1St St Ste G , Tustin CA 92780-2939. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bonnville, Heather K can be contacted via phone (714) 665-9890.

Contact Information

Primary practice address
661 W 1St St Ste G Tustin CA 92780-2939
Phone: (714) 665-9890
Fax: (714) 665-9891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA19271 California

Profile Details

NPI number 1770762429
LBN Legal business name Bonnville, Heather K
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2007
Last updated Feb 23rd, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770762429 NPPES
California MEDICAID 1770762429

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