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Organization
ERNESTO B. BANAAG, M.D., INC.
Active
Organization
ERNESTO B. BANAAG, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNESTO BELMONTE BANAAG M.D. (PRESIDENT)
(323) 254-1987
Entity
Organization
Contact information
Practice address
4034 VERDUGO RD, LOS ANGELES, CA 90065-3727
(323) 254-1987
(323) 254-3674
Mailing address
4034 VERDUGO RD, LOS ANGELES, CA 90065-3727
(323) 254-1987
(323) 254-3674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A36730
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A367300
—
CA
01
—
W20256
MEDICARE GROUP ID
CA
01
—
WA36730A
MEDICARE PPIN
CA
Enumeration date
12/19/2006
Last updated
11/13/2007
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