Provider Demographics
NPI:1780810044
Name:BONFIL, ALBERT DAVID (PSYD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:DAVID
Last Name:BONFIL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10921 WILSHIRE BLVD STE 901
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4000
Mailing Address - Country:US
Mailing Address - Phone:888-813-9613
Mailing Address - Fax:888-813-9613
Practice Address - Street 1:10921 WILSHIRE BLVD STE 901
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024
Practice Address - Country:US
Practice Address - Phone:888-813-9613
Practice Address - Fax:888-813-9613
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 25814103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral