Provider Demographics
NPI:1326312075
Name:BONEV, VALENTINA
Entity Type:Individual
Prefix:
First Name:VALENTINA
Middle Name:
Last Name:BONEV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S MAIN ST STE B-100
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3851
Mailing Address - Country:US
Mailing Address - Phone:714-571-5900
Mailing Address - Fax:
Practice Address - Street 1:230 S MAIN ST STE B-100
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3851
Practice Address - Country:US
Practice Address - Phone:714-571-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1392732086X0206X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology