Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | A69281 | CA |
NPI | 1457387805 |
---|---|
Provider Name | Dr. Sheila Marie Bonilla-Tandoc |
First Address | Arcadia, CA 91007-9269 |
Second Address | Arcadia, CA 91007-9269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 28/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A692810 | (05) | CA |
00A692810 | BLUE SHIELD (01) | CA |
00A692810197 | CAL OPTIMA (01) | CA |
1356390009 | GROUP NPI (01) | CA |
CE1617 | GROUP RAILROAD MEDICARE (01) | CA |
GR0016910 | GROUP MEDICAID PIN (01) | CA |
I62706 | (02) | CA |
W11675 | GROUP MEDICARE PIN (01) | CA |