Individual
MICHAELA B BANAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5671 SANTA TERESA BLVD, SAN JOSE, SAN JOSE, CA 95123-6512
(408) 284-2281
(408) 281-2857
Mailing address
7861 MURRAY AVE, GILROY, GILROY, CA 95020-4604
(408) 842-1017
(408) 842-4186
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
18329
CA
Other
Enumeration date
01/27/2009
Last updated
12/14/2012
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