Healthcare Provider Details

I. General information

NPI: 1528864261
Provider Name (Legal Business Name): BONETI PLASTIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 N BEDFORD DR STE 100
BEVERLY HILLS CA
90210-4308
US

IV. Provider business mailing address

416 N BEDFORD DR STE 100
BEVERLY HILLS CA
90210-4308
US

V. Phone/Fax

Practice location:
  • Phone: 305-951-6543
  • Fax: 424-324-3880
Mailing address:
  • Phone: 305-951-6543
  • Fax: 424-324-3880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CRISTIANO BONETI
Title or Position: OWNER
Credential: MD
Phone: 305-951-6543