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Organization
BANIPAL MEDICAL CORP
Active
Organization
BANIPAL MEDICAL CORP
Active
Other names
Advanced Vascular and Vein Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMPLEDEEP BANIPAL MD (VASCULAR SURGEON)
(818) 926-5272
Entity
Organization
Contact information
Practice address
355 E 21ST ST STE C, SAN BERNARDINO, CA 92404-4851
(818) 926-5272
(573) 250-7382
Mailing address
19400 TURTLE RIDGE LN, PORTER RANCH, CA 91326-3803
(818) 926-5272
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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