Provider Demographics
NPI:1841601382
Name:BONSU, OSEI
Entity Type:Individual
Prefix:
First Name:OSEI
Middle Name:
Last Name:BONSU
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:OSEI
Other - Middle Name:
Other - Last Name:BONSU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IDC
Mailing Address - Street 1:1ST LAR BATTALION AID STATION
Mailing Address - Street 2:41 AREA BRANCH HEALTH CLINIC
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055
Mailing Address - Country:US
Mailing Address - Phone:760-763-5251
Mailing Address - Fax:
Practice Address - Street 1:1ST LAR BATTALION AID STATION
Practice Address - Street 2:41 AREA BRANCH HEALTH CLINIC
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-763-5251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman