Provider Demographics
NPI:1376881250
Name:EARLY, BONNIE (PA-C)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:EARLY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:HINDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1825 4TH ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2350
Mailing Address - Country:US
Mailing Address - Phone:415-885-7528
Mailing Address - Fax:415-885-7711
Practice Address - Street 1:1825 4TH ST FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2350
Practice Address - Country:US
Practice Address - Phone:415-885-7528
Practice Address - Fax:415-885-7711
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08087363AM0700X
CAPA52522363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical