Organization
CRESENCIA D BANZUELA M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRESENCIA BANZUELA M.D. (DIRECTOR)
(951) 272-6595
Entity
Organization
Contact information
Practice address
260 E ONTARIO AVE, SUITE 204, CORONA, CA 92879-3506
(951) 272-6595
Mailing address
PO BOX 6038, CORONA, CA 92878-6038
(951) 272-3872
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/13/2006
Last updated
08/20/2008
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