Organization
LESAN BANKO, M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESANEMARIE T BANKO M.D. (CEO)
(760) 843-7675
Entity
Organization
Contact information
Practice address
12984 HESPERIA RD STE 100, VICTORVILLE, CA 92395-5819
(760) 843-7675
(760) 843-7649
Mailing address
12984 HESPERIA RD STE 100, VICTORVILLE, CA 92395-5819
(760) 843-7675
(760) 843-7649
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A104321
CA
Other
Enumeration date
12/09/2009
Last updated
03/17/2018
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