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Organization
EDGAR C BANEZ,MD
Active
Organization
EDGAR C BANEZ,MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR CORRALES BANEZ M.D. (OWNER)
(818) 786-8601
Entity
Organization
Contact information
Practice address
17216 SATICOY ST PMB 347, VAN NUYS, CA 91406-2103
(818) 786-8601
(818) 786-8643
Mailing address
7218 VAN NUYS BLVD STE D, VAN NUYS, CA 91405-2255
(818) 786-8601
(818) 786-8643
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A52430
CA
Other
Enumeration date
02/19/2007
Last updated
08/22/2020
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