| Doctor Name: | DUSTIN LEE BONHAM |
| NPI Number: | 1811082787 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | PT 25421 |
| Business Practice Address: | 2536 Rockwood Ave Calexico, CA - 922314407 |
| Business Phone Number: | 7607683422 |
| Business Fax Number: | 7607688408 |
| Mailing Address: | 5905 Severin Dr, LA MESA |
| State: | CA |
| Postal Code: | 919423806 |
| Phone Number: | 6195892606 |
| Fax Number: | 6194640900 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 04/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 25421 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |