Individual
DR. SANJAY BANSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3540 MENDOCINO AVENUE, SUITE 200, SANTA ROSA, CA 95403-3639
(707) 522-6200
(707) 522-6215
Mailing address
3540 MENDOCINO AVENUE, SUITE 200, SANTA ROSA, CA 95403-3639
(707) 522-6200
(707) 522-6215
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G66178
CA
Other
Enumeration date
07/11/2006
Last updated
07/09/2012
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