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1770219958
KEVIN JASON BONILLA
LOS ANGELES, CA
NPI
1770219958
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
172V00000X Community Health Worker
Enumeration Date
2022-07-28
Last Update Date
2023-06-15
Business Address
KEVIN JASON BONILLA B.A.
1433 S ROBERTSON BLVD
LOS ANGELES, CA 90035-3414
Phone number: 310-785-2121
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Mailing Address
KEVIN JASON BONILLA B.A.
1433 S ROBERTSON BLVD
LOS ANGELES, CA 90035-3414
Phone number: 310-785-2121
Copy
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