Individual
CRESENCIA DELEON BANZUELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
260 E ONTARIO AVE, SUITE 204, CORONA, CA 92879-3514
(951) 272-6595
(951) 272-3872
Mailing address
PO BOX 6038, CORONA, CA 92878-6038
(951) 272-6595
(951) 272-3872
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A53873
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A538730
—
CA
Enumeration date
07/13/2006
Last updated
02/27/2008
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