Edward Xavier Bonilla, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

22784 Issued in CA

Practice address

3989 W Stetson Ave Ste 105
Hemet, CA 92545-9697

Phone

(951) 652-3334

NPI assigned

Oct 7, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• All Star Physical Therapy

  • Physical Therapist
  • Murrieta, CA
  • NPI 1750559431
  Medicare reassignment NPD
• Elite Physical Therapy and Wellness, Inc.

  • Physical Therapist
  • La Quinta, CA
  • NPI 1780702209
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1003578006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE STE 201",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "951-200-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3989 W STETSON AVE STE 105",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925459697",
            "telephone_number": "951-652-3334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1090 N Palm Canyon Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624435",
            "country_code": "US",
            "telephone_number": "760-778-7150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33492 Oak Glen Rd Ste H",
            "address_purpose": "LOCATION",
            "city": "Yucaipa",
            "state": "CA",
            "postal_code": "923992096",
            "country_code": "US",
            "telephone_number": "909-797-1511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "EDWARD",
        "middle_name": "XAVIER",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "22784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T'Tonya Board-Casias
• Jothsna Bodhanapati, MD
• Maximiliano Bojorquez, PT DPT
• Zee Bolden MSW Asw
• M Michael Boldy, MD
• Jared Bonner
• Stephanie Bonty
• Kavida Boozer
• Robert Paul Bos, OTR/L
• Marco Antonio Bosquet, MD

• Occupational Therapist in Hemet, CA
• Providers in Hemet, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.