Annemarie Miranda Bonilla, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

301279 Issued in CA

Practice address

11460 W Washington Blvd
Los Angeles, CA 90066-6030

Phone

(310) 337-7115

NPI assigned

Nov 24, 2021

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Therapy West, Inc

  • Occupational Therapist
  • Los Angeles, CA
  • NPI 1225232523
  NPD

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1477210466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913434848",
            "telephone_number": "415-328-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11460 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666030",
            "telephone_number": "310-337-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "ANNEMARIE",
        "middle_name": "MIRANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2025-02-14",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "301279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonanzin Bonilla Flores, LVN
• Beatris Bonilla Garcia
• Taiz Bonilla-Avelar
• Sheila Marie Bonilla-Tandoc, MD, MS
• Allen Bonilla, D.C.
• Argentina Bonilla
• Ashley Veronica Bonilla
• Christian Bonilla
• Delsie Gutierrez Bonilla, LMFT
• Ericka Bonilla, LCSW

• Pediatric Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.