Individual
MUSSA BANISADRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 MELROSE AVE, SUITE A, MODESTO, CA 95350-5508
(209) 524-7000
(209) 527-5601
Mailing address
1325 MELROSE AVE, SUITE A, MODESTO, CA 95350-5508
(209) 524-7000
(209) 527-5601
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A38740
CA
Other
Enumeration date
05/19/2006
Last updated
04/14/2008
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