institution
Dante A. Banta, M.d., Inc.
Primary Care Clinic/Center in Los Angeles, California
NPI 1215100417

Dante A. Banta, M.d., Inc. is a Primary Care Clinic/Center based in Los Angeles, CA and is specialized in Primary Care. Dante A. Banta, M.d., Inc. practices in Los Angeles, CA. The NPI Number for Dante A. Banta, M.d., Inc. is 1215100417 and holds a License No. A44079 (California).

The current practice location address for Dante A. Banta, M.d., Inc. is 875 N Western Ave, Los Angeles, CA and can be reached out via phone at 323-461-0777 and via fax at 323-461-8035.

Location: 875 N Western Ave, Los Angeles, CA, 90029-3759
institution
Provider Profile Details
NPI Number
1215100417
Provider Name
Dante A. Banta, M.d., Inc.
Credential
Provider Entity Type
Organization
Address
875 N Western Ave, Los Angeles, CA, 90029-3759
Phone Number
323-461-0777
Fax Number
323-461-8035
Provider Enumeration Date
04/08/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A440791 05 CA
institution
Provider Business Practice Location Address Details
Address
875 N Western Ave
City
State
Zip
90029-3759
Phone Number
323-461-0777
Fax Number
323-461-8035
person
Provider Business Mailing Address Details
Address
875 N Western Ave
City
State
Zip
90029-3759
Phone Number
323-461-0777
Fax Number
323-461-8035
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
A44079 (California)
Definition
Definition to come...
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