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General NPI Number Information
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NPI Number | 1285947952
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Entity Type | Individual
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Provider Name | RICHARD BENJAMIN BONNES PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | NMRTC CP 41 AREA MCMH 200 MERCY CIRCLE
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City | CAMP PENDLETON
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State | CA
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Zip | 92055
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Country | US
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Telephone | 760-725-1861
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Fax |
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Provider Business Mailing Address
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Address Line | NMRTC CP 41 AREA MCMH 200 MERCY CIRCLE
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City | CAMP PENDLETON
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State | CA
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Zip | 92055
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Country | US
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Telephone | 760-725-1861
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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