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Organization
M L BANIGO MD INC
Active
Organization
M L BANIGO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAY LOLO BANIGO M.D. (PRESIDENT)
(818) 845-6206
Entity
Organization
Contact information
Practice address
900 S ATLANTIC BLVD, MONTEREY PARK, CA 91754-4716
(626) 570-9000
(626) 570-5775
Mailing address
101 S 1ST ST, 1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A661850
BLUE SHIELD
CA
05
—
00A661850
—
CA
Enumeration date
08/05/2006
Last updated
03/02/2011
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