MEDICARE: L. A. BONNESEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1194851048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	L. A. BONNESEN

Provider Business Mailing Address
First Line	:	3310 W BELL RD
Second Line	:	#249
City	:	PHOENIX
State	:	AZ
Zip	:	85053-2925
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3310 W BELL RD
Second Line	:	#249
City	:	PHOENIX
State	:	AZ
Zip	:	85053-2925
Country	:	US
Telephone Number	:	602-280-2602
Fax Number	:	602-866-7759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	09/11/2025

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Directions to “ L. A. BONNESEN ” Practice Location

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