Individual
MR. MIGUEL ANGEL BANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
57475 29 PALMS HWY, SUITE 101, YUCCA VALLEY, CA 92284-2906
(760) 365-9878
(206) 309-0387
Mailing address
57475 29 PALMS HWY, SUITE 101, YUCCA VALLEY, CA 92284-2906
(760) 365-9878
(206) 309-0387
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
7009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7009
CERTIFIED MASSAGE THERAPIST
CA
Enumeration date
03/23/2010
Last updated
03/23/2010
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