Healthcare Provider Details

I. General information

NPI: 1811296866
Provider Name (Legal Business Name): ARAM BONNI, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25108 MARGUERITE PKWY A-259
MISSION VIEGO CA
92692
US

IV. Provider business mailing address

25108 MARGUERITE PKWY A-259
MISSION VIEGO CA
92692
US

V. Phone/Fax

Practice location:
  • Phone: 310-770-1706
  • Fax: 866-545-3197
Mailing address:
  • Phone: 310-770-1706
  • Fax: 866-545-3197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: ARAM BONNI
Title or Position: PRESIDENT/MEDICAL DOCTOR
Credential: M.D.
Phone: 310-770-1706