Charles Edward Bonfanti, PA
NPI #1295792570 in Taos, New Mexico
Provider Information
- NPI Number
- 1295792570
- Entity Type
- Individual
- Name
- Charles Edward Bonfanti, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Apr 28, 2006
- Last Updated
- Feb 3, 2017
Practice Location
- Address
- 630 PASEO DEL PUEBLO SUR
- Address 2
- SUITE 150
- City
- Taos
- State
- New Mexico
- ZIP Code
- 87571-6070
- Phone
- (575) 758-3005
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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