Individual
DR. PUSHPENDU BANERJEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9850 GENESEE AVE STE 560, LA JOLLA, CA 92037-1229
(858) 552-1410
(858) 552-0929
Mailing address
PO BOX 25100, FRESNO, CA 93729-5100
(559) 326-1222
(559) 326-1230
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
A69490
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A694900
—
CA
01
—
A69490
MEDICAL LICENSE
CA
Enumeration date
02/17/2006
Last updated
01/23/2020
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