Most Relevant Information
Provider Data
| NPI Number: | 1003578006 |
| Provider Name: | EDWARD XAVIER BONILLA OT |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 22784 |
Most Important Dates
| Enumeration Date: | 10/07/2021 |
| Last Updated: | 10/07/2021 |
Provider Practice Location
3989 W STETSON AVE STE 105
HEMET
CA
925459697
Practice Location Phone/Fax
| Phone: | 9516523334 |
| Fax: |
Provider Mailing Location
24630 WASHINGTON AVE STE 201
MURRIETA
CA
925626177
Provider Mailing Phone/Fax
| Phone: | 9512003620 |
| Fax: |