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Individual
DR. MARJAN BANOONI
Active
Individual
DR. MARJAN BANOONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A82603
CA
207QA0000X
Adolescent Medicine (Family Medicine) Physician
A82603
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518983063
A82603
CA
05
—
1518983063
—
CA
01
—
A82603
STATE LICENSE
CA
Enumeration date
07/15/2006
Last updated
12/09/2019
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