Individual
STEPHEN BANISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1117 E MAIN ST, SUITE C, GRASS VALLEY, CA 95945-5716
(530) 274-2274
Mailing address
1117 E MAIN ST, SUITE C, GRASS VALLEY, CA 95945-5716
(530) 274-2274
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
G23826
CA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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