Most Relevant Information
Provider Data
| NPI Number: | 1003585340 |
| Provider Name: | CARLOS JACOB BONILLA |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/09/2021 |
| Last Updated: | 10/06/2023 |
Provider Practice Location
2621 OSWELL ST
BAKERSFIELD
CA
933063172
Practice Location Phone/Fax
| Phone: | 6618686750 |
| Fax: |
Provider Mailing Location
PO BOX 1000
BAKERSFIELD
CA
933021000
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |