Individual
SIMPLEDEEP BANIPAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505-3043
(951) 353-2000
Mailing address
12791 BLUSH CT, RIVERSIDE, CA 92503-7008
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125057681
IL
2086S0129X
Vascular Surgery Physician
Primary
A154251
CA
Other
Enumeration date
12/03/2012
Last updated
04/13/2025
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