Lookup NPI Numbers from the NPI Registry
NPI Profile for JACOB BONILLA in DOUGLAS, AZ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI # | 1417300096 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/19/2016 | |
| Last updated | 03/21/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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JACOB BONILLA