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Individual
MARK S. BANASIAK
Active
Individual
MARK S. BANASIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC23625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0236251
MEDICARE ID
CA
01
—
ZZZ63647Y
BLUE SHIELD
—
Enumeration date
10/17/2006
Last updated
01/12/2024
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