Provider Demographics
NPI:1477601771
Name:BONSALL UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BONSALL UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STAINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-631-5218
Mailing Address - Street 1:31505 OLD RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-5112
Mailing Address - Country:US
Mailing Address - Phone:760-631-5200
Mailing Address - Fax:760-631-5219
Practice Address - Street 1:31505 OLD RIVER RD
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-5112
Practice Address - Country:US
Practice Address - Phone:760-631-5200
Practice Address - Fax:760-631-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37-67975OtherMEDI-CAL