Provider Demographics
NPI:1104718865
Name:BONNEL, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BONNEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2672 RANDALL WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4423
Mailing Address - Country:US
Mailing Address - Phone:510-387-9336
Mailing Address - Fax:
Practice Address - Street 1:7901 STONERIDGE DR STE 150
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3502
Practice Address - Country:US
Practice Address - Phone:925-417-8733
Practice Address - Fax:925-417-8733
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program