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Individual

DR. FIRAS BANNOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
11370 ANDERSON ST, SUITE B-100, LOMA LINDA, CA 92354-3450
(909) 558-2880
Mailing address
11370 ANDERSON ST, SUITE B-100, LOMA LINDA, CA 92354-3450
(909) 558-2880

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
A100375
CA
2084N0600X
Clinical Neurophysiology Physician
Primary
A100375
CA

Other

Enumeration date
01/13/2009
Last updated
01/08/2014
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