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General NPI Number Information
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NPI Number | 1780810044
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Entity Type | Individual
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Provider Name | ALBERT DAVID BONFIL PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 08/03/2018
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Provider Practice Location Address
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Address Line | 10921 WILSHIRE BLVD STE 901
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City | LOS ANGELES
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State | CA
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Zip | 90024
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Country | US
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Telephone | 888-813-9613
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Fax | 888-813-9613
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Provider Business Mailing Address
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Address Line | 10921 WILSHIRE BLVD STE 901
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City | LOS ANGELES
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State | CA
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Zip | 90024-4000
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Country | US
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Telephone | 888-813-9613
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Fax | 888-813-9613
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY 25814
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License Number State | CA
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