Individual
EDDIE BANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 HAMPTON DRIVE, ST JOSEPH CENTER, VENICE, CA 90291
(310) 396-6468
(310) 392-8402
Mailing address
204 HAMPTON DRIVE, ST JOSEPH CENTER, VENICE, CA 90291
(310) 396-6468
(310) 392-8402
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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