Provider Demographics
NPI:1053168468
Name:BONFIGLI CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:BONFIGLI CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONFIGLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-395-7270
Mailing Address - Street 1:840 ONEILL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3852
Mailing Address - Country:US
Mailing Address - Phone:650-395-7270
Mailing Address - Fax:
Practice Address - Street 1:840 ONEILL ST APT 1
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3852
Practice Address - Country:US
Practice Address - Phone:650-395-7270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty