Provider Demographics
NPI:1699303206
Name:BONTE, ALEXANDER HARMON (MB, BCH, BAO)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:HARMON
Last Name:BONTE
Suffix:
Gender:M
Credentials:MB, BCH, BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W ROSEBURG AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5147
Mailing Address - Country:US
Mailing Address - Phone:415-858-3250
Mailing Address - Fax:
Practice Address - Street 1:360 ESSEX ST STE 402
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-8566
Practice Address - Country:US
Practice Address - Phone:551-996-2016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program