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NPI Code Detail

MEDICARE: WILLIAM F BONK LVN

MEDICARE: WILLIAM F BONK LVN
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
1164X00000XLicensed Vocational NurseVN172518CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235289760
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM F BONK LVN
Provider Business Mailing Address
First Line : 2202 RICHLAND AVE APT 4
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-1359
Country : US
Telephone Number : 323-664-6727
Fax Number :
Provider Business Practice Location Address
First Line : 1111 W 6TH ST STE 111
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-1823
Country : US
Telephone Number : 213-482-6400
Fax Number : 213-482-6408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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