Active NPI
Bonifacio Coronel Fontanilla
- Certified Respiratory Therapist
- Chino Hills, CA
National Provider Identifier
1063992014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Respiratory Therapist
- License
- 14762
- Practice address
- 2363 Scenic Ridge Dr
Chino Hills, CA 91709 - Phone
- (909) 210-1931
- NPI assigned
- Aug 20, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Respiratory Therapist | 227800000X | 14762 | CA | Primary |
Addresses
Primary practice location
2363 Scenic Ridge Dr
Chino Hills, CA 91709
Mailing address
3440 E la Palma Ave
Anaheim, CA 92806-2020
Phone (714) 644-7570
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14762 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1063992014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3440 E LA PALMA AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928062020",
"telephone_number": "714-644-7570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2363 SCENIC RIDGE DR",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "91709",
"telephone_number": "909-210-1931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTANILLA",
"first_name": "BONIFACIO",
"middle_name": "CORONEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "227800000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Certified",
"state": "CA",
"license": "14762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.