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Individual

AMY P BANSAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2080 CENTURY PARK E STE 710, LOS ANGELES, CA 90067-2010
(310) 715-3237
Mailing address
PO BOX 1475, WALNUT, CA 91788-1475
(909) 973-0150

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A167507
CA
207Y00000X
Otolaryngology Physician
MD-47306
IA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
A167507
CA

Other

Enumeration date
04/28/2014
Last updated
03/02/2022
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