SOUTHWEST COMPREHENSIVE PAIN MANAGEMENT LLC
Ambulatory Health at Bramble Berry Ln, Phoenix, AZ

License number
Arizona 32912
Category
Ambulatory Health
Type
Pain
Owner
Name: DR. GABRIEL LUIS BONILLA MD
Title: MEDICAL DIRECTOR AND LLC MEMBER
Phone: (623) 780-1563
Address
Address
1749 W Bramble Berry Ln, Phoenix, AZ 85085
National Provider ID: 1316114663
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SOUTHWEST COMPREHENSIVE PAIN MANAGEMENT, LLC

1749 W Bramble Berry Ln, Phoenix, AZ 85085

Registration:
Apr 30, 2008
State ID:
L-1447064-7
Expiration:
PERPETUAL
Managers:
Gabriel L Bonilla Md (Manager), 1749 W Bramble Berry Ln, Phoenix, AZ 85085 (Physical),Ana Maria Lugo (Manager), 1749 W Bramble Berry Ln, Phoenix, AZ 85085 (Physical)
Agent:
Ivelisse Bonilla Esq,Awerkamp & Bonilla, Tucson, AZ 85701 (Physical)

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