Individual
JUSTIN LEE BANAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 POTRERO AVENUE, BLDG. 5 , 1ST FL, SAN FRANCISCO, CA 94110
(628) 206-8020
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A152793
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2016
Last updated
11/16/2023
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