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1346869781
SAM BONGE
WEST HOLLYWOOD, CA
NPI
1346869781
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-04-15
Last Update Date
2020-04-15
Business Address
SAM BONGE
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048-1804
Phone number: 310-423-3277
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Mailing Address
SAM BONGE
1254 N CLEAVER ST APT 1
CHICAGO, IL 60642-3310
Phone number: 416-454-0569
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