Provider Demographics
NPI:1689779209
Name:BONIS, WILLIAM EARLE (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EARLE
Last Name:BONIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7555
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-7555
Mailing Address - Country:US
Mailing Address - Phone:530-332-3890
Mailing Address - Fax:530-893-6907
Practice Address - Street 1:265 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2273
Practice Address - Country:US
Practice Address - Phone:530-332-3890
Practice Address - Fax:530-893-6907
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53478207RH0003X
WAMD61518247207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1689779209Medicaid
CA1689779209Medicare NSC
G76566Medicare UPIN